The Relation Between Parent Stress and Children's Communication Skills Following a Theatre-Based Intervention for Children with Autism Spectrum Disorder

Background:  It is well established that parents of children with autism spectrum disorder experience more stress than those with typically developing children or another disability. Further, previous studies demonstrate an inverse relation between children’s adaptive behaviors and parental stress. Impairments in social communication appear particularly stressful. In the current study, parents rated their stress before and after their child participated in a social skills intervention, and likewise also rated their child’s adaptive functioning skills pre- and post-intervention. 

Objectives:   This study evaluates the impact of a theatre-based, social skills intervention for children with ASD. The 10-session program incorporates theatrical approaches, trained typically developing peers, and established behavioral strategies with the aim of increasing children’s social functioning. A primary objective of this investigation was to examine the impact of a child-focused intervention on parental stress, and further, whether parental stress is related to their child’s functional outcomes.Methods:  

Methods: Participants included 30 youth with ASD between 8 to 16 years randomly assigned to the Experimental treatment group (EXP, N = 17) and Wait-list control group (WLC, N = 13). Parent stress was measured using the Parenting Stress Index- Short Form. This version of the PSI is comprised of 36 items divided into 3 subscales: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child. It also includes a total parental stress score. Children’s adaptive behavior, including social, communication, home living, and self-care skills, was measured with the Adaptive Behavior Assessment System-II. Nonparametric, Independent Samples Mann-Whitney U Test was used in which the post-intervention score served as the outcome variable and group (EXP or WLC) as the main independent variable. 

Results:  Significant differences were observed between the EXP and the WLC groups on the PSI Parent Distress (PD) scale (p = 0.039). Significant differences were also observed between the EXP and WLC groups for the ABAS-II Communication scale (p = 0.039). Pearson correlations indicated a significant relation between parents’ post-intervention total stress (PSI Total Score) and children’s post-intervention communication skills (ABAS-II Communication), r  = -.381, p = .038. 

Conclusions: This study extends previous findings about the relation of parent stress to child characteristics of ASD within a novel, theatre-based intervention design. Specifically, the distress parents experienced (in their parental role) was significantly less for the EXP group parents whose children received the theatre-based social skills intervention as compared to the WLC parents. At the same time, children who participated in the intervention demonstrated a significant increase in their adaptive communication skills compared to the wait-list controls. The findings further suggest that stronger child communication skills are related to less parental overall stress. The importance of child-focused interventions for parent well-being is discussed.