Meta-analysis of the Efficacy and Effectiveness of Parent Child Interaction Therapy (PCIT) for Child Behaviour Problems

• Luis Valero-Aguayo ^[1] ; María Rodríguez-Bocanegra ^[2] ; Rafael Ferro-García ^[2] ; Lourdes Ascanio-Velasco ^[2]
  1. [1] Universidad de Málaga

     Universidad de Málaga

     Málaga, España

     
  2. [2] Centro Psicología CEDI (Granada)
• Localización: Psicothema, ISSN-e 1886-144X, ISSN 0214-9915, Vol. 33, Nº. 4, 2021, págs. 544-555
• Idioma: inglés
• DOI: 10.7334/psicothema2021.70
• Títulos paralelos:
  • Meta-análisis Sobre la Efi cacia y Efectividad de la Terapia de Interacción Padres-Hijos (PCIT) Para Problemas de Conducta Infantil
• Enlaces
  • Texto completo (pdf)
• Dialnet Métricas: 3 Citas
• Resumen
  • español

    Antecedentes: la Terapia de Interacción Padres-Hijos (PCIT) es un tratamiento bien establecido para los problemas de conducta infantil.

    Los meta-análisis previos son escasos y mezclan problemas y medidas.

    Objetivo: realizar un meta-análisis con todos los estudios disponibles sobre PCIT (1980 a 2020) para conocer su efi cacia y efectividad sobre los problemas de conducta infantil. Método: la selección fi nal recogió 100 estudios. Los criterios de inclusión fueron: comparar la PCIT en niños con diversos problemas de conducta; comparar grupos y utilizar instrumentos estandarizados. Resultados: PCIT ha mostrado un tamaño del efecto medio signifi cativo (d = -0,87 [IC 95%: -1,10, -0,63] frente a grupos de control y/o tratamientos usuales; pero ha sido menor y no signifi cativo en los seguimientos (d = -0,23 [IC 95%: -0,49, 0,04]). Los estudios que comparan versiones de PCIT también han mostrado un tamaño del efecto signifi cativo (d = -0,26 [IC del 95%: -0,43, -0,08]), al igual que los intra-grupo con un efecto mayor (d = -1,40 [IC del 95%: -1,69, -1,10]).

    Conclusiones: la PCIT es una intervención efi caz para el tratamiento de los problemas de conducta infantil, disruptivas, hiperactivas, negativistas y externalizantes. Está avalada por 40 años de estudios experimentales y clínicos, y también en este meta-análisis

  • English

    Background: Parent-Child Interaction Therapy (PCIT) is a wellestablished treatment for behavioural, hyperactivity and oppositionaldefi ant problems in children. Previous meta-analyses are scarce, and they have tended to mix problems and measures. Objective: A meta-analysis study was conducted with all available studies on PCIT (1980 to 2020) to determine its specifi c effi cacy and effectiveness for child behavioural problems. Method: Selection from databases collected a total of 100 studies. The inclusion criteria were to compare PCIT in children with behavioural problems between 2 and 12 years of age; comparing groups and using standardized instruments. Results: PCIT exhibited a signifi cant mean effect size (d = -0.87 [95% CI: -1.10, -0.63] versus control and/ or treatment-as-usual groups, but the effect size was smaller and not signifi cant in follow-ups (d = -0.23 [95% CI: -0.49, 0.04]). The withingroup studies, comparing versions of PCIT, also demonstrated a signifi cant effect size (d = -0.26 (95% CI: -0.43, -0.08), and in pre-post comparisons this effect was greater (d = -1.40 [95% CI: -1.69, -1.10]). Conclusions:

    PCIT is an effective intervention for treating child behaviour problems such as disruptive, hyperactive, negative, and externalizing problems. It is supported by 40 years of experimental and clinical studies, and also by this meta-analysis

• Referencias bibliográficas
  • *Abrahamse, M.E. (2015). Treating young chihldren’s disruptive behavior problems. Dissemination of an evidence-based management training program...
  • *Abrahamse, M.E., Junger, M., Van-Wouwe, M.A.M.M., Boer, F., & Lindauer, R.J.L. (2016). Treating child disruptive behavior in high-risk...
  • *Acosta, J., García, D., & Bagner, D.M. (2019). Parent-Child Interaction Therapy for children with developmental delay: The role of sleep...
  • *Allen, K., Harrington, J.W., & Cooke, C. (2018). PCIT for children with severe behavior problems and autism spectrum disorder. In C.B....
  • *Allen, B., Timmer, S.G., & Urquiza, A.J. (2014). Parent-Child Interaction Therapy as an attachment-based intervention: Theoretical rationale...
  • *Allen, B., Timmer, S.G., & Urquiza, A.J. (2016). Parent-Child Interaction Therapy for sexual concerns of maltreated children: A preliminary...
  • *Bagner, D.M., & Eyberg, S.M. (2003). Father involvement in parent training: When does it matter? Journal of Clinical Child and Adolescent...
  • *Bagner, D.M., & Eyberg, S.M. (2007). Parent-Child Interaction Therapy for disruptive behavior in child with mental retardation: A randomized...
  • *Bagner, D.M., Graziano, P.A., Jaccard, J., Sheinkopf, S.J., Vohr, B.R., & Lester, B.M. (2012). An initial investigation of baseline respiratory...
  • *Bagner, D.M., Rodríguez, G.M., Blake, C.A., & Rosa-Olivares, J. (2013). Home-based preventive parenting intervention for at-risk infants...
  • *Bagner, D.M., Sheinkopf, S.J., Vohr, B.R., & Lester, B.M. (2010). Parenting intervention for externalizing behavior problems in children...
  • *Barnett, M.L., Niec, L.N., Peer, S.O., Jent, J.F., Weinstein, A., Gisbert, P., & Simpson, G. (2015). Successful therapist-parent coaching:...
  • *Berkovits, M.D., O’Brien, K.A, Carter, C.G., & Eyberg, S.M. (2010). Early identification and intervention for behavior problems in primary...
  • *Bjørseth, Â., & Wichstrøm, L. (2016). Effectiveness of Parent-Child Interaction Therapy (PCIT) in the treatment of young children’s behavior...
  • *Blair, K., Topitzes, J., & Mersky, J.P. (2019). Do parents’ adverse childhood experiences influence treatment responses to Parent-Child...
  • *Boggs, S.R., Eyberg, S.M., Edwards, D.L., Rayfi eld, A., Jacobs, J., Bagner, D., & Hood, K.K. (2005). Outcomes of Parent-Child Interaction...
  • Brabson, L.A., Jackson, C.B., Liebsack, B.K., & Herschell, A.D. (2018). PCIT: Summary of 40 years of research. In C. B. McNeil et al....
  • *Brestan, E.V., Eyberg, S.M., Boggs, S.R., & Algina, J. (1997). Parent-Child Interaction Therapy: Parents’ perceptions of untreated siblings....
  • *Briegel, W., Walter, T., Schimek, M., Knapp, D., & Bussing, R. (2015). Parent-Child Interaction Therapy in in-room-coaching. Kindheit...
  • *Budd, K.S., Garbacz, L.L., & Carter, J.S. (2016). Collaborating with public school partners to implement Teacher-Child Interaction Training...
  • California Evidence-Based Clearinghouse for Child Welfare (2020). Parent-Child Interaction Therapy. http://www.cebc4cw.org/program/ parent-child-interaction-therapy/detailed
  • *Capage, L.C., Bennet, G.M., & McNeil, C.B. (2001). A comparison between African and Caucasian children referred for treatment of disruptive...
  • *Chaffin, M., Silovsky, J.F., Funderburk, B., Valle, L.A., Brestan, E.V., Balachova, T., Jackson, S., Lensgraf, J., & Bonner, B.L. (2004)....
  • *Chase, R.M., & Eyberg, S.M. (2008). Clinical presentation and treatment outcome for children with comorbid externalizing and internalizing...
  • *Chase, R.M., Carmody, K.A., Lent, M., Murphy, R., Amaya-Jackson, L. Wray, E., Ake III, G.S., Sullivan, K., White, D., Gurwitch, R., Murray,...
  • *Chen, Y., & Fortson, B.L. (2015). Predictors of treatment attrition and treatment length in Parent-Child Interaction Therapy in Taiwanese...
  • *Chronis-Tuscano, A., Lewis-Morrarty, E., Woods, K.E., O’Brien, K.A., Mazursky-Horowitz, H., & Thomas, S.R. (2016). Parent-Child Interaction...
  • *Comer, J.S., Furr, J.M., Miguel, E.M., Cooper-Vice, C.E., Carpenter, A.L., Elkins, R.M., Kerns, C.E., Cornacchio, D., Chou, T., Coxe, S.,...
  • *Comer, J.S., Puliafico, A.C., Aschenbrand, S.G., McKnight, K., Robin, J.A., Goldfine, M.E., & Albano, A.M. (2011). A pilot feasibility...
  • Cooley, M.E., Veldorale-Griffi n, A., Petren, R.E., & Mullis, A.K. (2014). Parent-Child Interaction Therapy: A meta-analysis of child...
  • *Davis, R.F., Brestan-Knight, E., Gillis, J.M., & Travis, J.K. (2018). Improving Parent-Child Relationships through the use of video technology....
  • *Danko, C.M., Garbacz, L.L., & Budd, K.S. (2016). Outcomes of Parent-Child Interaction Therapy in an urban community clinic: A comparison...
  • *Eisenstadt, T.H., Eyberg, S., McNeil, C.B., Newcomb, K., & Funderburk, B. (1993). Parent-Child Interaction Therapy with behavior problem...
  • Euser, S., Alink, L. RA., Stoltenborgh, M., Bakermans-Kranenburg, M.J., & van Ijzendoorn, M.H. (2015). A Gloomy picture: A meta-analysis...
  • Eyberg, S.M. (1988). Parent-Child Interaction Therapy: Integration of traditional and behavioral concerns. Child & Family Behavior Therapy,...
  • Eyberg, S.M., & Pincus, D. (1999). Sutter-Eyberg Student Behavior Inventory-Revised: Professional Manual. Psychological Assessment Resources....
  • Eyberg, S.M., & Ross, A.W. (1978). Assessment of child behavior problems: The validation of a new inventory. Journal of Clinical Child...
  • *Eyberg, S., Boggs, S., & Jaccard, J. (2014). Does maintenance treatment matter? Journal of Abnormal Child Psychology, 42, 355-366. https://...
  • Eyberg, S.M., & Funderburk, B. (2011). Parent Child Interaction Therapy Protocol 2011 [Unpublished manuscript]. http://www.pcit.org/store/...
  • *Eyberg, S.M., Funderburk, B.W., Hembree-Kigin, T.L., McNeil, C.B., Querido, J.G., & Hood, K.K. (2001). Parent-Child Interaction Therapy...
  • Eyberg, S.M., & Johnson, S.M. (1974). Multiple assessment of behavior modification with families: Effects of contingency contracting and...
  • *Fernández, M.A., Butler, A.M., & Eyberg, S.M. (2011). Treatment outcome for low socioeconomic status African American families in Parent-Child...
  • Ferro-García, R., & Ascanio-Velasco, L. (2017). Terapia de Interacción Padres-Hijos. Un tratamiento basado en la evidencia [Parent-Child...
  • Ferro-García, R., Rodríguez-Bocanegra, M., & Ascanio-Velasco, L. (2020). Una revisión sistemática de la efectividad y eficacia de la Terapia...
  • *Foley, K., McNeil, C.B., Norman, M., & Wallace, N.M. (2016). Effectiveness of group format Parent-Child Interaction Therapy compared...
  • *Fowles, T.R., Masse, J.J., McGoron, L., Beveridge, R.M., Williamson, A.A., Smith, M.A., & Parrish, B.P. (2018). Home-based vs. clinic-based...
  • *Funderburk, B.W., Eyberg, S.M., Newcomb, K., McNeil, C.B., HembreeKigin, T., & Capage, L. (1998). Parent-Child Interaction Therapy with...
  • *Fukurawa, K., Okuno, H., Mohri, I, Nakanishi, M., Eyberg, S.M., & Sakai, S. (2018). Effectiveness of Child-Directed Interaction Training...
  • *Galanter, R., Self-Brown, S., Valente, J.R., Dorsey, S., Whitaker, D.J., Bertuglia-Haley, M., & Prieto, M. (2012). Effectiveness of Parent-Child...
  • Gallagher, N. (2003). Effects of Parnt-Child Interaction Therapy on young children with disruptive behavior disorders. Bridges, 1(4), 1-17.
  • *Garbacz, L.L., Zychinski, K.E., Feuer, R.M., Carter, J.S., & Budd, K.S. (2014). Effects of Teacher-Child Interaction Training (TCIT)...
  • García-Torne, S., Calzada, E.J., Eyberg, S.M., Mas, J.C., Vilamala, C., Baraza, C., Villena, H., González, M., Calvo, M., & Trinant, A....
  • *Ginn, N.C., Clionsky, L.N., Eyberg, S.M., Warner-Metzger, C., & Abner, J.P. (2017). Child-directed interaction training for young children...
  • Girard, E.I, Wallace, N.M., Kohlhoff, J.R., Morgan, S.S.J., & McNeil, C.B. (2018). Parent-Child Interaction Therapy with toddlers: Improving...
  • *Graziano, P.A., Bagner, D.M., Slavec, J., Hungerford, G., Kent, K., Babinski, D., Berefi nko, K., & Pasalich, D. (2015). Feasibility...
  • *Gresl, B.L., Fox, R.A., & Fleischmann, A. (2014). Home-based ParentChild Therapy in low-income African American, Caucasian, and Latino...
  • *Gross, D., Belcher, H.M.E., Budhathoki, C., Ofonedu, M.E., & Uveges, M.K. (2018). Does parent training format affect treatment engagement?...
  • *Gross, D.A., Belcher, H.M.E., Budhathoki, C., Ofonedu, M.E., Dutrow, D., Uveges, M.K., & Slade, E. (2019). Reducing preschool behavior...
  • *Harwood, M.D., & Eyberg, S. M. (2004). Therapist verbal behavior early in treatment: Relation to successful completion of Parent-Child...
  • *Harwood, M.D., & Eyberg, S.M.(2006). Child-Directed Interaction: Prediction of change in impaired mother-child functioning. Journal of...
  • *Herschell, A.D., Capage, L.C., Bahl, A.B., & McNeil, C.B. (2008). The role of therapist communication style in Parent-Child Interaction...
  • *Herschell, A.D., Scudder, A.B., Schaffner, K.F., & Slagel, L.A. (2017). Feasibility and effectiveness of Parent-Child Interaction Therapy...
  • *Hood, K.K., & Eyberg, S.M. (2003). Outcomes of Parent-Child Interaction Therapy: Mothers’ reports maintenance three to six years after...
  • Kennedy, S.C., Kim, J., Tripodi, S.J., Brown, S.M., & Gowdy, G. (2016). Does Parent-Child Interaction Therapy reduce future physical abuse?...
  • *Kimonis, E.R., Fleming, G., Briggs, N., Brouwer-French, L., Frick, P.J., Hawes, D.J., Bagner, D.M., Thomas, R., & Dadds, M. (2018). Parent-Child...
  • *Kohlhoff, J., & Morgan, S. (2014). Parent-Child Interaction Therapy for toddlers: A pilot study. Child & Family Behavior Therapy,...
  • *Lanier, P., Kohl, P.L., Benz, J., Swinger, D., & Drake, B. (2014). Preventing maltreatment with a community-based implementation of Parent-Child...
  • *Lanier, P., Kohl, P.L., Benz, J., Swinger, D., Moussette, P., & Drake, B. (2011). Parent-Child Interaction Therapy in a community setting:...
  • *Lenze, S.N., Pautsch, J., & Luby, J. (2011). Parent-Child Interaction Therapy emotion development: A novel treatment for depression in...
  • *Leung, C., Tsang, S., Heung, K., & Yiu, I. (2009). Effectiveness of Parent-Child Interaction Therapy (PCIT) among Chinese families. Research...
  • *Leung, C., Tsang, S., Ng, G.S.H., & Choi, S.Y. (2017). Efficacy of Parent-Child Interaction Therapy with Chinese ADHD children: Randomized...
  • *Leung, C., Tsang, S., Sin, S., & Choi, S.Y. (2015). The efficacy of Parent-Child Interaction Therapy with Chinese families: Randomized...
  • *Lieneman, C.C., Quetsch, L.B., Theodorou, L.L., Newton, K.A., & McNeil, C.B. (2019). Reconceptualizing attrition in Parent-Child Interaction...
  • *Lieneman, C.C., Girard, E.I., Quetsch, L.B., & McNeil, C.B. (2020). Emotion regulation and attrition in Parent-Child Interaction Therapy....
  • *Lyon, A.R., & Budd, K.S. (2010). A community mental health implementation of Parent-Child Interaction Therapy (PCIT). Journal Child &...
  • *Matos, M., Bauermeister, J.J., & Bernal, G. (2009). Parent-Child Interaction Therapy for Puerto Rican preschool children with ADHD and...
  • *Matos, M., Torres, R., Santiago, R., Jurado, M., & Rodríguez, I. (2006). Adaptation of Parent-Child Interaction Therapy for Puerto Rican...
  • *McCabe, K., & Yeh, M. (2009). Parent-Child Interaction Therapy for Mexican Americans: A randomized clinical trial. Journal of Clinical...
  • *McCabe, K., Yeh, M., Lau, A., & Argote, C.B. (2012). Parent-Child Interaction Therapy for Mexican Americans: Results of a pilot randomized...
  • *McInnis, P., Kohlhoff, J., & Eapen, V. (2020). Real-world outcomes of PCIT for children at risk of autism or developmental delay. Journal...
  • *McNeil, C.B., Capage, L.C., Bahl, A., & Blanc, H. (1999). Importance of early intervention for disruptive behavior problems: Comparison...
  • *McNeil, C.B., Eyberg, S., Eisenstadt, T.H., Newcomb, K., & Funderburk, B. (1991). Parent-Child Interaction Therapy with behavior problem...
  • McNeil, C.B., & Hembree-Kigin, T.L. (2011). Parent-Child Interaction Therapy. Second Edition. Springer.
  • McNeil, C.B., Quetsch, L.B., & Anderson, C.M. (2018). Handbook of Parent-Child Interaction Therapy for children on the Autism Spectrum....
  • *Mersky, J.P., Topitzes, J., & Blair, K. (2017). Translating evidence-based treatment into child welfare services through communicateuniversity...
  • *Mersky, J.P., Topitzes, J., Grant-Savela, S.D., Brondino, M.J., & McNeil, C.B. (2016). Adapting Parent-Child Interaction Therapy to foster...
  • *Niec, L., Barnett, M.L., Prewett, M.S., & Shanley, J. (2016). Group Parent-Interaction Therapy: A randomized control trial for the treatment...
  • *Niec, L.N, Shanley, J.R., Barnett, M.L., Baker, S.E., & Solomon, D.T. (2015). Optimal or typical performance? The impact of instructional...
  • *Nieter, L., Thornberry, T., & Brestan-Knight, E. (2013). The effectiveness of group Parent-Child Interaction Therapy with community families....
  • *Nixon, R.D., Sweeney, L., Erikson, D.B., & Touyz, S.W. (2003). Parent-Child Interaction Therapy: A comparison of standard and abbreviated...
  • *Nixon, R.D., Sweeney, L., Erikson, D.B., & Touyz, S.W. (2004). One-and-two-year follow-up of standard and abbreviates treatments for...
  • *Pade, H., Taube, D.O., Aalborg, A.E., & Reiser, P.J. (2006). An immediate and long-term study of a temperament and Parent-Child Interaction...
  • *Parlade, M.V., Weinstein, A., García, D., Rowley, A.M., Ginn, N.C., & Jent, J. F. (2020). Parent-Child Interaction Therapy for children...
  • *Pearl, E., Thieken, L., Olafson, E., Boat, B., Connelly, L., Barnes, J., & Putnam, F. (2012). Effectiveness of community dissemination...
  • *Phillips, J., Morgan, S., Cawthorne, K., & Barnett, B. (2008). Pilot evaluation of Parent-Child Interaction Therapy delivered in an Australian...
  • *Riley, V.T. (2014). The effect of Parent-Child Interaction Therapy on caregiver rigidity, job satisfaction and childhood misbehavior [Doctoral...
  • *Rodríguez, G.M., Bagner, D.M., & Graziano, P.A. (2014). Parent training for children born premature: A pilot study examining the moderating...
  • *Rothenberg, W.A., Weinstein, A., Dandes, E.A., & Jent, J.F. (2019). Improving child emotion regulation: Effects of Parent-Child InteractionTherapy...
  • *Schuhmann, E.M., Foote, R.C., Eyberg, S.M., Boggs, S.R., & Algina, J. (1998). Efficacy of Parent-Child Interaction Therapy: Interim report...
  • *Scudder, A.T., Wong, C.B., Mendoza-Burcham, M., & Handen, B. (2018). Summary of lessons learned from two studies: An open clinical trial...
  • *Self-Brown, S., Valente, J.R., Wild, R.C., Whitaker, D.J., Galanter, R., Dorsey, S., & Stanley, J. (2012). Utilizing benchmarking to...
  • *Solomon, M., Ono, M., Timmer, S., & Goodlin-Jones, B. (2008). The effectiveness of Parent-Child Interaction Therapy for families of children...
  • Southam-Gerow, M.A., & Prinstein, M.J. (2014). Evidence base updates: The evolution of the evaluation of psychological treatments for...
  • *Stokes, J.O., Jent, J.F., Weinstein, A., Davis, E.M., Brown, T.M., Cruz, L., & Wavering, H. (2016). Does practice make perfect? The relationship...
  • *Stokes, J.O., Wallace, N.M., & McNeil, C.B. (2018) Effectiveness of community-delivered Parent-Child Interaction Therapy compared to...
  • Thomas, R., Abell, B., Webb, H.J., Avdagic, E., & Zimmer-Gembeck, M.J. (2007). Behavioral outcomes of Parent-Child Interaction Therapy...
  • Thomas, R., Abell, B., Webb, H.J., Avdagic, E., & Zimmer-Gembeck, M.J. (2017). Parent-Child Interaction Therapy: A meta-analysis, Pediatrics,...
  • *Thomas, R., & Zimmer-Gembeck, M.J. (2011). Accumulating evidence for Parent-Child Interaction Therapy in the prevention of child Maltreatment....
  • *Tiano, J.D., & McNeil, C.B. (2006). Training Head Start teachers in behavior management using Parent-Child Interaction Therapy: A preliminary...
  • *Timmer, S.G., Ho, L.K.L., Urquiza, A.J., Zebell, N.M., Fernández-García, E., & Boys, D. (2011). The effectiveness of Parent-Child Interaction...
  • *Timmer, S.G., Urquiza, A.J., & Zebell, N. (2006). Challenging foster caregiver-maltreated child relationships: The effectiveness of Parent-Child...
  • *Timmer, S.G., Urquiza, A.J., Boys, D.K, Forte, L.A., Quick-Abdullah, D., Chan, S., & Gould, W. (2016). Filling potholes on the implementation...
  • *Timmer, S.G., Zebell, N.C., Culver, M.A., & Urquiza, A.J. (2010a). Efficacy of adjunct in-home coaching to improve outcomes in Parent-Child...
  • *Timmer, S.G., Ware, L.M., Urquiza, A.J., & Zebell, N.M. (2010b). The effectiveness of Parent-Child Interaction Therapy for victims of...
  • Title IV-E Prevention Services Clearinghouse (2020). Parent-Child Interaction Therapy. https://preventionservices.abtsites.com/programs/155/show/
  • *Veen-Mulders, L., Hoofdakker, B.J., Nauta, M.H., Emmelkamp, P., & Hoekstra, P.J. (2018). Methylphenidate has superior efficacy over Parent-Child...
  • *Wallace, N.M., Quetsch, L.B., Robinson, C., McCoy K.M., & McNeil, C.B. (2018). Infusing Parent-Child Interaction Therapy principles into...
  • Ward, M.A., Theule, J., & Cheung, K. (2016). Parent-Child Interaction Therapy for child disruptive behaviour disorders: A meta-analysis....
  • *Webb, H.J., Thomas, R., McGregor, L., Avdagic, E., & Zimmer-Gembeck, M.J. (2017). An Evaluation of Parent-Child Interaction Therapy with...
  • *Werba, B.E., Eyberg, S.M., Boggs, S.R., & Algina, J. (2006). Predicting outcome in Parent-Child Interaction Therapy: Success and attrition....
  • *Zimmer-Gembeck, M.J., Kerin, J.L., Webb, H.J., Gardner, A.A., Campbell, S.M., Swan, K., & Timmer, S.G. (2019). Improved perceptions of...
  • *Zlomke, K.R., & Jeter, K. (2019). Comparative effectiveness of Parent-Child Interaction Therapy for children with and without autism...
  • *Zlomke, K.R., Jeter, K., & Murphy, J. (2017). Open-trial pilot of Parent-Child Interaction Therapy for children with autism spectrum...