What parent was ever trained or taught about how to manage communication - the hardest part of parenting in autism?

Introducing Parent Training, Family Coaching, and PACT Communication Therapy at Houston Specialty Clinic

You know your child better than anyone. You also know the moments that wear you down: the twenty-minute standoff over homework, the meltdown when the tablet goes away, the feeling that you're negotiating a treaty every single afternoon. Or maybe it's something quieter — your two-year-old isn't using words yet, and you're not sure how to reach him.

None of that means you're doing it wrong. It means you're missing tools that nobody handed you.

That's what these services are for.

What Parent Training Actually Is

Parent training is coaching for you — practical, specific, and built around your family's real schedule.

We don't hand you a pamphlet on consistency and send you home. We sit down, look at what a Tuesday afternoon actually looks like in your house, and rebuild it piece by piece: what happens when your child walks in the door, when homework starts, how chores get assigned, what earns screen time and what doesn't.

Then we teach you the strategies that make it hold.

The core idea: give control over how, not whether

Many of the children we see have a strong drive for independence and control. When that drive collides with a direct command, you get a power struggle. When it's given somewhere useful to go, you get cooperation.

So instead of "You need to do your homework now," we teach:

"Would you like to start with math or reading?"

Instead of "Clean the table," we teach:

"Would you like to clean the table before or after you feed the dog?"

The expectation doesn't change. The child's sense of ownership does. Families are often surprised by how quickly the arguing drops off.

What we build together

• A predictable after-school routine — arrival, snack, decompression, a real choice period, homework in manageable segments, chores, dinner. Structured, but with flexibility built in on purpose.

• A reward system that works — visual, consistent, and tied to effort rather than mood. Many of our families use a shared family calendar system so the plan lives on the wall instead of in your head.

• Homework strategies — breaking assignments into smaller pieces, offering choice about order, location, and break timing, and reinforcing along the way rather than only at the finish line.

• Less micromanaging — one of the most common breakthroughs we see is a parent stepping back and a child stepping up. One parent recently reported her son doing the laundry entirely on his own, then coming to ask for extra Roblox time as a reward. He understood the deal. That's the goal.

• Groundwork for independent sleep — behavioral sleep goals fit naturally into the same framework, and we plan them in stages.

Every few sessions you get a written plan update: what's improved, what we're targeting next, your goals as a caregiver, and the specific strategies to practice before we meet again.

Family Coaching: Practicing It Live

Some skills are easier to learn by doing them with support in the room. In family coaching, your child joins the session and we practice together in real time — communication, transitions, routines, responding in the moment.

It's the same program as parent training, just with a live audience of one.

Video Review and Feedback

With your permission, you record a short, ordinary interaction with your child at home. We watch it together and talk through it.

This is not an evaluation of your parenting. It's strength-based: we look for the moments where something you did worked — often something you didn't even notice — and we build on those. Parents consistently tell us this is the session where things click.

PACT Communication Therapy

For parents of children ages 2–11 with expressive speech delays or a new autism diagnosis.

PACT is a structured, evidence-based, parent-mediated communication program. That word matters: this is not therapy your child receives while you sit in the waiting room, and it isn't a group class. It's a program that teaches you to become the most effective communication partner your child has — because you're the one who's there all day, every day.

Using video of your own interactions with your child, we work through six stages in sequence:

Stage	Focus
Intake	Understanding your child, your family, and where to begin
Stage 1	Shared Attention — building moments of genuine joint focus
Stage 2	Synchrony & Sensitivity — reading and matching your child's pace and signals
Stage 3	Language Input — pitching your language to where your child actually is
Stage 4	Routines & Anticipation — using repetition and predictability to invite communication
Stage 5	Communication Functions — helping your child communicate to request, share, protest, connect
Stage 6	Expansion & Conversation — stretching single exchanges into back-and-forth

Format: 12 biweekly sessions total, with optional monthly maintenance sessions once all stages are complete.

What you walk away with isn't a technique you used in the clinic. It's a different way of being with your child at the kitchen table, in the car, at bath time.

Why We Chose These Approaches

We are a specialty medical practice, and we don't add a service unless the evidence behind it is real. Here is what the published research shows.

PACT has the longest-running evidence of any parent-mediated autism intervention

The original trial randomized 152 children aged 2 to 4 years with autism across three UK specialist centers to PACT plus usual care, or usual care alone.¹

The children were then reassessed nearly six years after treatment ended, at ages 7 to 11. Autism symptom severity was significantly lower in the children whose parents had received PACT — a difference that was present at the end of treatment and still present almost six years later.² These are the first results to demonstrate sustained, long-term symptom reduction following an early autism intervention, something that had previously been considered very difficult to achieve.

A Cochrane systematic review of parent-mediated early interventions for autism found an overall reduction in symptom severity compared with control conditions across the trials examined.³ A later trial extended the PACT approach to combine work at home with work in the child's educational setting.⁴

One honest note: the original trial enrolled preschool-aged children with core autism. The published evidence is strongest for that group. Amy will talk with you frankly about how well the research maps onto your child.

The parent-coaching model itself is well supported

A meta-analysis synthesizing 77 published evaluations of parent training programs for children aged 0–7 found that the components associated with the largest effects were exactly the ones we emphasize: building positive parent-child interaction and emotional communication skills, parenting consistency, and — critically — having parents practice the skills rather than only hear about them.⁵

That last finding is why we use live family coaching and video review instead of handing you a workbook.

What this asks of you

In the original PACT trial, parents attended sessions over roughly six months with continued support afterward, and committed to about 20–30 minutes per day of planned communication and play with their child at home.⁶

We tell families this up front, because the daily practice at home is where the change actually happens. The sessions are where you learn how.

Meet Your Educator

Working Under the Supervision of Dr. Rotenberg

Amy Igbokwe, M.S.Ed., ABA 

Assistant Diagnostician | Communication & Behavior Specialist

Amy has been a key pillar at Houston Specialty Clinic for years. As a behavior specialist, she has spent more than seven years helping young children with autism, expressive language delays, behavioral challenges, and developmental differences build stronger communication skills.

Trained in Applied Behavior Analysis, she specializes in parent-mediated communication interventions, autism assessment, and early-childhood behavior therapy. She is known for her warm, collaborative approach and her ability to translate evidence-based strategies into simple, empowering tools families can use every day.

Our Services at a Glance

Service	What It Is	Length
Assessment & Planning (required first visit)	Comprehensive intake to understand your child's needs and family dynamics, and to build an individualized plan	45–60 min
Parent Training (parents only)	One-on-one coaching in behavior management, routines, organization, and putting recommendations into practice	30 / 45 / 60 min
Family Coaching (child present)	Live coaching with your family to practice skills and build consistent routines in real time	30 / 45 / 60 min
Video Review & Feedback	Review of a recorded parent-child interaction with targeted, strength-based feedback	Per session
PACT Communication Therapy	Structured parent-mediated communication program using video feedback	12 biweekly sessions, with optional monthly maintenance

Every family begins with the Assessment & Planning visit so that what follows is built for your child, not for a generic one.

A Note on Cost and Insurance

These are non-covered educational services. Parent training, family coaching, video review, and PACT are educational and skills-based — they are not billed to insurance, and they are not covered benefits under health plans. Payment is due at the time of service.

We know that matters when you're deciding, so we'd rather you hear it from us up front than discover it later. Our office will give you the full fee schedule for every service before you commit to anything, and we're glad to walk you through what a typical course of care looks like so there are no surprises.

Getting Started

If any of this sounds like your house — the homework standoffs, the screen-time battles, the worry about words that haven't come yet — call us to schedule an Assessment & Planning visit.

You don't need a referral, and you don't need to know exactly what you need. Call and ask for Amy Igbokwe, our Assistant Diagnostician and Communication & Behavior Specialist, and she'll help you figure out where to start.

Phone: 713-464-4107 Fax: 713-465-4522

Established patients can also reach us through the Patient Portal.

Our Locations

Frostwood – Memorial City 902 Frostwood Drive, Suite 210 Houston, TX 77024

References

1. 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. Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. Lancet. 2010;375(9732):2152–2160. doi:10.1016/S0140-6736(10)60587-9

2. Pickles A, Le Couteur A, Leadbitter K, Salomone E, Cole-Fletcher R, Tobin H, Gammer I, Lowry J, Vamvakas G, Byford S, Aldred C, Slonims V, McConachie H, Howlin P, Parr JR, Charman T, Green J. Parent-mediated social communication therapy for young children with autism (PACT): long-term follow-up of a randomised controlled trial. Lancet. 2016;388(10059):2501–2509. doi:10.1016/S0140-6736(16)31229-6

3. Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2013;(4):CD009774.

4. Green J, Leadbitter K, Ellis C, et al. Combined social communication therapy at home and in education for young autistic children in England (PACT-G): a parallel, single-blind, randomised controlled trial. Lancet Psychiatry. 2022;9(4):307–320.

5. Kaminski JW, Valle LA, Filene JH, Boyle CL. A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol. 2008;36(4):567–589. doi:10.1007/s10802-007-9201-9

6. Preschool Autism Communication Trial (PACT) treatment protocol, as described in references 1 and 2.

Houston Specialty Clinic — Pediatric Neurology | Pediatric Pulmonology | Pediatric and Adult Sleep Medicine | Nutrition

This article is general education and information. It is not a substitute for the medical care and advice of your physician. Any images of people accompanying this post are not actual patients.