magazinelogo

Journal of Psychology and Behavioral Studies

ISSN Online: 3067-4972 CODEN:
Frequency: Instant publication Email: JPBS@hillpublish.com
Total View: 153252 Downloads: 9457 Citations: 1 (From Dimensions)
ArticleOpen Access http://dx.doi.org/10.26855/jpbs.2025.12.001

The Effect of Parent–child Interaction Therapy (PCIT) on Attachment Relationships in Children with Autism Spectrum Disorder: A Systematic Review

Yichi Zhang

Fudan University, Shanghai 200438, China.

*Corresponding author: Yichi Zhang

Published: October 13,2025

Abstract

Children with Autism Spectrum Disorder (ASD) often experience difficulties developing secure attachment relationships due to impairments in emotional communication, social reciprocity, and caregiver responsiveness. While Parent–Child Interaction Therapy (PCIT) is well established as an effective intervention for reducing disruptive behaviors and improving parent–child interactions, its potential impact on attachment-related outcomes within ASD populations remains insufficiently examined. This systematic review aims to synthesize current evidence on the effects of PCIT on attachment-related constructs in children with ASD, including child compliance, mutual responsiveness, and caregiver–child relational quality. Following PRISMA 2020 guidelines, electronic searches were conducted across four major databases for peer-reviewed studies published between 2000 and 2024. A total of seven documents met the inclusion criteria, six conducted in the United States and one in Iran, with participant samples representing diverse ethnic backgrounds including White, Black, and Hispanic families. Although attachment was not the primary outcome in most included studies, all assessed dimensions are theoretically linked to attachment security, such as parental sensitivity, dyadic synchrony, and child behavioral responsiveness. Findings suggest that PCIT, particularly in ASD-adapted formats, may positively influence caregiver–child relationship quality and support the development of secure attachment. This review highlights a critical gap in the literature and underscores the need for future research employing formal attachment measures and longitudinal designs to clarify PCIT’s broader relational benefits for families affected by ASD.

Keywords

Autism Spectrum Disorder; Parent–child Interaction Therapy; Attachment; Care-giver–child relationship; Parent-mediated intervention

References

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation (pp. xviii-391). Lawrence Erlbaum.

Allen, K., Harrington, J., Quetsch, L. B., Masse, J., Cooke, C., & Paulson, J. F. (2023). Parent–Child Interaction Therapy for Children with Disruptive Behaviors and Autism: A Randomized Clinical Trial. Journal of Autism and Developmental Disorders, 53(1), 390-404. https://doi.org/10.1007/s10803-022-05428-y

Bowlby, J. (1999). Attachment and loss (2nd ed.). Basic Books.

Cassidy, J. (1994). Emotion regulation: Influences of attachment relationships. Monographs of the Society for Research in Child Development, 59(2-3), 228-249.

Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20(3), 775-803. https://doi.org/10.1017/S0954579408000370Diagnostic and statistical manual of mental disorders: DSM-5(5th ed.). (2013). American Psychiatric Association.

Eyberg, S. M., & Nelson, M. M. (2004). Feedback is invited on any aspect of this document.

Funderburk, B. W., & Eyberg, S. (2011). Parent–child interaction therapy. In History of psychotherapy: Continuity and change (2nd ed., pp. 415-420). American Psychological Association. https://doi.org/10.1037/12353-021

Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., Le Couteur, A., Leadbitter, K., Hudry, K., Byford, S., Barrett, B., Temple, K., Macdonald, W., Pickles, A., & PACT Consortium. (2010). Parent-mediated communication-focused treatment in children with autism (PACT): A randomised controlled trial. The Lancet, 375(9732), 2152-2160. https://doi.org/10.1016/S0140-6736(10)60587-9

Hatamzadeh, A., Pouretemad, H., & Hassanabadi, H. (2010). The effectiveness of parent – child interaction therapy for children with high functioning autism. Procedia - Social and Behavioral Sciences, 5, 994-997. https://doi.org/10.1016/j.sbspro.2010.07.224

Herschell, A. D., Calzada, E. J., Eyberg, S. M., & McNeil, C. B. (2002). Parent-child interaction therapy: New directions in research. Cognitive and Behavioral Practice, 9(1), 9-16. https://doi.org/10.1016/S1077-7229(02)80034-7

Masse, J. J., McNeil, C. B., Wagner, S., & Quetsch, L. B. (2016). Examining the Efficacy of Parent–Child Interaction Therapy with Children on the Autism Spectrum. Journal of Child and Family Studies, 25(8), 2508-2525. https://doi.org/10.1007/s10826-016-0424-7

Moss, E., Cyr, C., & Dubois-Comtois, K. (2004). Attachment at early school age and developmental risk: Examining family contexts and behavior problems of controlling-caregiving, controlling-punitive, and behaviorally disorganized children. Developmental Psychology, 40(4), 519-532. https://doi.org/10.1037/0012-1649.40.4.519

Ros, R., & Graziano, P. A. (2019). Group PCIT for Preschoolers with Autism Spectrum Disorder and Externalizing Be-havior Problems. Journal of Child and Family Studies, 28(5), 1294-1303. https://doi.org/10.1007/s10826-019-01358-z

Ros-DeMarize, R., Boan, A., Bradley, C., Klein, J., & Carpenter, L. (2025). Tele-PCIT: Initial Examination of Internet Delivered PCIT for Young Children with Autism. Child Psychiatry & Human Development, 56(1), 101-110. https://doi.org/10.1007/s10578-023-01539-4

Rutgers, A. H., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., & van Berckelaer-Onnes, I. A. (2004). Autism and attachment: A meta-analytic review. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45(6), 1123-1134. https://doi.org/10.1111/j.1469-7610.2004.t01-1-00305.x

Solomon, M., Ono, M., Timmer, S., & Goodlin-Jones, B. (2008). The Effectiveness of Parent–Child Interaction Therapy for Families of Children on the Autism Spectrum. Journal of Autism and Developmental Disorders, 38(9), 1767-1776. https://doi.org/10.1007/s10803-008-0567-5

Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, W. A. (2005). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood (pp. xvi-384). Guilford Publications.

Teague, S. J., Gray, K. M., Tonge, B. J., & Newman, L. K. (2017). Attachment in children with autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 35, 35-50. https://doi.org/10.1016/j.rasd.2016.12.002

Thomas, R., & Zimmer-Gembeck, M. J. (2012). Parent–Child Interaction Therapy: An Evidence-Based Treatment for Child Maltreatment. Child Maltreatment, 17(3), 253-266.
https://doi.org/10.1177/1077559512459555

Thomas, R., Abell, B., Webb, H. J., Avdagic, E., & Zimmer-Gembeck, M. J. (2017). Parent-Child Interaction Therapy: A Meta-analysis. Pediatrics, 140(3), e20170352.
https://doi.org/10.1542/peds.2017-0352

Tyler, E. T., Hulkower, R. L., & Kaminski, J. W. (2017). Behavioral Health Integration in Pediatric Primary Care:

Vess, S. F., & Campbell, J. M. (2022). Parent–child interaction therapy (PCIT) with families of children with autism spectrum disorder. Autism & Developmental Language Impairments, 7, 23969415221140707. 

https://doi.org/10.1177/23969415221140707

Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23(2-3), 143-152. https://doi.org/10.1016/j.ijdevneu.2004.05.001

How to cite this paper

The Effect of Parent–child Interaction Therapy (PCIT) on Attachment Relationships in Children with Autism Spectrum Disorder: A Systematic Review

How to cite this paper: Yichi Zhang. (2025). The Effect of Parent–child Interaction Therapy (PCIT) on Attachment Relationships in Children with Autism Spectrum Disorder: A Systematic Review. Journal of Psychology and Behavioral Studies1(2), 50-61.

DOI: http://dx.doi.org/10.26855/jpbs.2025.12.001