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The Impact of Parent-Delivered Intervention on Parents of Very Young Children with Autism

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Abstract

This study investigated the impact of a parent-coaching intervention based on the Early Start Denver Model (P-ESDM) on parenting-related stress and sense of competence. This was part of a multisite, randomized trial comparing P-ESDM (n = 49) with community intervention (n = 49) for children aged 12 and 24 months. The P-ESDM group reported no increase in parenting stress, whereas the Community group experienced an increase over the same 3-month period. Parental sense of competence did not differ. Number of negative life events was a significant predictor of parenting stress and sense of competence across both groups. This suggests that a parent-coaching intervention may help maintain parental adjustment directly after a child is diagnosed with ASD.

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References

  • Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., & Murphy, M. M. (2004). Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile × syndrome. American Journal of Mental Retardation, 109(3), 237–254.

    Article  PubMed  Google Scholar 

  • Baker-Ericzen, M. J., Brookman-Frazee, L., & Stahmer, A. (2005). Stress levels and adaptability in parents of toddlers with and without autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 30(4), 194–204.

    Article  Google Scholar 

  • Barker, E. T., Hartley, S. L., Selzer, M. M., Floyd, F. J., Greenberg, J. S., & Orsmond, G. I. (2011). Trajectories of emotional well-being in mothers of adolescents and adults with autism. Developmental Psychology, 47(2), 551–561.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bishop, S. L., Guthrie, W., Coffing, M., & Lord, C. (2011). Convergent validity of the Mullen Scales of Early Learning and the Differential Ability Scales in children with autism spectrum disorders. American Journal on Intellectual and Developmental Disabilities, 116, 331–343.

    Article  PubMed  Google Scholar 

  • Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioral disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50(Pt 3), 184–198.

    Article  PubMed  Google Scholar 

  • Brookman-Frazee, L. (2004). Using parent/clinician partnerships in parent education programs for children with autism. Journal of Positive Behavior Interventions, 6(4), 195–213.

    Article  Google Scholar 

  • Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). A randomized controlled trial of Hanen’s “More Than Words” in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741–752.

    Article  PubMed  Google Scholar 

  • Dawson, G., Rogers, S. J., Smith, M., Munson, J., Winter, J., Greenson, J., et al. (2010). Randomized controlled trial of the Early Start Denver Model. Pediatrics, 125, 1–7.

    Article  Google Scholar 

  • Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., et al. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism. European Child and Adolescent Psychiatry, 11, 266–272.

    Article  PubMed  Google Scholar 

  • Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development. Exceptionality, 2(2), 97–110.

    Article  Google Scholar 

  • Eisenhower, A. S., Baker, B. L., & Blacher, J. (2005). Preschool children with intellectual disability: Syndrome specificity, behavior problems, and maternal well-being. Journal of Intellectual Disability Research, 49(Pt 9), 657–671.

    Article  PubMed Central  PubMed  Google Scholar 

  • Elliott, C. D. (1990). Differential Ability Scales. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X. H., & Abbott, R. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4), 375–387.

    Article  PubMed  Google Scholar 

  • Estes, A., Olson, E., Sullivan, K., Greenson, J., Winter, J., Dawson, G., et al. (2012). Parenting-related stress and psychological distress in mothers of toddlers with autism spectrum disorders. Brain & Development, 35, 133–138. doi:10.1016/j.braindev.2012.10.004.

    Article  Google Scholar 

  • Feldman, F. A., & Wener, S. E. (2002). Collateral effects of behavioral parent training on families of children with developmental disabilities and behavior disorders. Behavioral Interventions, 17(2), 75–83.

    Article  Google Scholar 

  • Gallagher, J. J., & Bristol, M. (1989). Families of young handicapped children. In M. C. R. M. C. Wang & H. J. Walberg (Eds.), Handbook of special education: Research and practice (3rd ed., Vol. 3, pp. 295–317). New York: Pergamon.

    Google Scholar 

  • Gray, D. E. (2003). Gender and coping: The parents of children with high functioning autism. Social Science and Medicine, 56(3), 631–642.

    Article  PubMed  Google Scholar 

  • Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V., Howlin, P., et al. (2010). Parent-mediated communication-focused treatment in children with autism (PACT): A randomised controlled trial. The Lancet, 375, 2152–2160.

    Article  Google Scholar 

  • Greenberg, J. S., Seltzer, M., Krauss, M., Chou, R. J., & Hong, J. (2004). The effect of quality of the relationship between mothers and adult children with schizophrenia, autism, or Down syndrome on maternal well-being: The mediating role of optimism. American Journal of Orthopsychiatry, 74(1), 14–25.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hanft, B. E., Rush, D. D., & Shelden, M. L. (2004). Coaching families and colleagues in early childhood. Baltimore, MD: Paul H. Brookes Publishing Co.

    Google Scholar 

  • Harris, S. L., Wolchik, S. A., & Milch, R. E. (1982). Changing the speech of autistic children and their parents. Child and Family Behavior Therapy, 4, 151–173.

    Article  Google Scholar 

  • Hastings, R. P., & Brown, T. (2002). Behavior problems of children with autism, parental self-efficacy, and mental health. American Journal of Mental Retardation, 107(3), 222–232.

    Article  PubMed  Google Scholar 

  • Hastings, R. P., & Johnson, E. (2001). Stress in UK families conducting intensive home-based behavioral intervention for their young child with autism. Journal of Autism and Developmental Disorders, 31(3), 327–336.

    Article  PubMed  Google Scholar 

  • Hertz-Picciotto, I., Croen, L. A., Hansen, R., Jones, C. R., van de Water, J., & Pessah, I. N. (2006). The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism. Environmental Health Perspectives, 114(7), 1119–1125.

    Article  PubMed Central  PubMed  Google Scholar 

  • Higgins, D. J., Bailey, S. R., & Pearce, J. C. (2005). Factors associated with functioning style and coping strategies of families with a child with an autism spectrum disorder. Autism, 9(2), 125–137.

    Article  PubMed  Google Scholar 

  • Johnston, C., & Mash, E. J. (1989). A measure of parenting satisfaction and efficacy. Journal of Clinical Child Psychology, 18(2), 167–175.

    Article  Google Scholar 

  • Kasari, C., & Sigman, M. (1997). Linking parental perceptions to interactions in young children with autism. Journal of Autism and Developmental Disorders, 27(1), 39–57.

    Article  PubMed  Google Scholar 

  • Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), 347–359.

    Article  PubMed  Google Scholar 

  • Koegel, R. L., Schreibman, L., Britten, K. R., Burke, J. C., & O’Neill, R. E. (1982). A comparison of parent training to direct child treatment. In R. L. Koegel, A. Rincover, & A. L. Egel (Eds.), Educating and understanding autistic children. San Diego, CA: College-Hill Press.

    Google Scholar 

  • Konstantareas, M. M., & Homatidis, S. (1989). Assessing child symptom severity and stress in parents of autistic children. Journal of Child Psychology and Psychiatry, 30(3), 459–470.

    Article  PubMed  Google Scholar 

  • Konstantareas, M. M., Homatidis, S., & Plowright, C. M. (1992). Assessing resources and stress in parents of severely dysfunctional children through the Clarke modification of Holroyd’s questionnaire on resources and stress. Journal of Autism and Developmental Disorders, 22(2), 217–234.

    Article  PubMed  Google Scholar 

  • Kuhn, J. C., & Carter, A. S. (2006). Maternal self-efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry, 76(4), 564–575.

    Article  PubMed  Google Scholar 

  • Laski, K. E., Charlop, M. H., & Schreibman, L. (1988). Training parents to use the natural language paradigm to increase their autistic children’s speech. Journal of Applied Behavior Analysis, 21, 391–400.

    Article  PubMed  Google Scholar 

  • Luyster, R., Gotham, K., Guthrie, W., Coffing, M., Petrak, R., Pierce, K., et al. (2009). The Autism Diagnostic Observation Schedule-Toddler Module: A new module of a standardized diagnostic measure for autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1305–1320.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mak, W. S., Ho, A. H. Y., & Law, R. W. (2007). Sense of coherence, parenting attitudes and stress among mothers of children with autism in Hong Kong. Journal of Applied Research in Intellectual Disabilities, 20(2), 157–167.

    Article  Google Scholar 

  • McConachie, H., & Diggle, T. (2007). Parent implemented early intervention for young children with autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice, 13, 120–129.

    Article  PubMed  Google Scholar 

  • Mullen, E. M. (1997). Mullen scales of early learning. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Oosterling, I., Visser, J., Swinkels, S., Rommelse, N., Donders, R., Woudenberg, T., et al. (2010). Randomized controlled trial of the focus parent training for toddlers with autism: 1-Year outcome. Journal of Autism and Developmental Disorders, 40, 1447–1458.

    Article  PubMed Central  PubMed  Google Scholar 

  • Orsmond, G. I., Lin, L., & Selzer, M. M. (2007). Mothers of adolescents and adults with ASD: Parenting multiple children with disabilities. Intellectual and Developmental Disabilities, 45(4), 257–270.

    Article  PubMed  Google Scholar 

  • Osborne, L. A., McHugh, L., Saunders, J., & Reed, P. (2008). A possible contra-indication for early diagnosis of Autism Spectrum Conditions: Impact on parenting stress. Research in Autism Spectrum Disorders, 2(4), 707–715.

    Article  Google Scholar 

  • Rodrigue, J. R., Morgan, S. B., & Geffken, G. (1990). Families of autistic children: Psychological functioning of mothers. Journal of Clinical Child Psychology, 19(4), 371–379.

    Article  Google Scholar 

  • Rogers, S. J., & Dawson, G. (2010). The Early Start Denver model for young children with autism: Promoting language, learning, and engagement. New York, NY: Guilford Press, 2010.

    Google Scholar 

  • Rogers, S. J., Dawson, G., Vismara, L. (2012). Unpublished manual, P-ESDM Fidelity Tool.

  • Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., et al. (2012b). Effects of a brief Early Start Denver Model (ESDM)-based parenting intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rogers, H., & Matthews, J. (2004). The parenting sense of competence scale: Investigation of the factor structure, reliability, and validity for an Australian sample. Australian Psychologist, 39, 88–96.

    Article  Google Scholar 

  • Salt, J., Shemilt, J. C., Sellars, V., Boyd, S., Coulsdon, T., & McCool, S. (2002). The Scottish Centre for Autism Preschool Treatment Programme II: The results of a controlled treatment outcome study. Autism, 6, 33–46.

    Article  PubMed  Google Scholar 

  • Sarason, I., Johnson, J., & Siegal, J. (1978). Assessing the impact of life changes: Development of the live experiences survey. Journal of Consulting and Clinical Psychology, 46, 932–946.

    Article  PubMed  Google Scholar 

  • Schreibman, L., Kaneko, W. M., & Koegel, R. L. (1991). Positive affect of parents of parents of autistic children—A comparison across 2 teaching techniques. Behavior Therapy, 22(4), 479–490. doi:10.1016/S0005-7894(05)80340-5.

    Article  Google Scholar 

  • Schwichtenberg, A., & Poehlmann, J. (2007). Applied behavior analysis: Does intervention intensity relate to family stressors and maternal well-being? Journal of Intellectual Disability Research, 51(8), 598–605.

    Article  PubMed  Google Scholar 

  • Shields, J. (2001). The NAS earlybird programme: Partnership with parents in early intervention. Autism, 5, 49–56.

    PubMed  Google Scholar 

  • Smith, T., Groen, A., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 104, 269–285.

    Article  Google Scholar 

  • Smith, L. E., Mailick Seltzer, M., Tager-Flusberg, H., Greenberg, J. S., & Carter, A. S. (2008). A comparative analysis of well-being and coping among mothers of toddlers and mothers of adolescents with ASD. Journal of Autism and Developmental Disorders, 38, 876–889.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stahmer, A. C., & Gist, K. (2001). The effects of an accelerated parent education program on technique mastery and child outcome. Journal of Positive Behavior Interventions, 3, 75–82.

    Article  Google Scholar 

  • Tonge, B., Brereton, A., Kiomall, M., Mackinnon, A., King, N., & Rinehart, N. (2006). Effects on parental mental health of an education and skills training program for parents of young children with autism: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 45(5), 561–569.

    Article  PubMed  Google Scholar 

  • VanBelle, H., Fischer, L., Heagerty, P. J., & Lumley, T. (2004). Biostatistics: A methodology for the health sciences (2nd ed., p. 465). New York: Wiley Interscience.

    Book  Google Scholar 

  • White, N., & Hastings, R. P. (2004). Social and professional support for parents of adolescents with severe intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 17(3), 181–190.

    Article  Google Scholar 

  • Wong, J. D., Selzer, M., Greenberg, J., et al. (2012). Stressful life events and daily stressors affect awakening cortisol level in midlife mothers of individuals with autism spectrum disorders. Aging and Mental Health, 16(8), 939.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

We wish to thank the parents, caregivers, and children who participated in this study. This research was supported by Grants from the National Institute of Health (MH81757) and Autism Speaks (1720).

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Correspondence to Annette Estes.

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Estes, A., Vismara, L., Mercado, C. et al. The Impact of Parent-Delivered Intervention on Parents of Very Young Children with Autism. J Autism Dev Disord 44, 353–365 (2014). https://doi.org/10.1007/s10803-013-1874-z

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