Early Intervention Services and Effects on Parent Stress

Background:  

Parents of children with Autism Spectrum Disorder (ASD) experience greater parenting stress than parents of children who are typically developing and children with other disabilities. A recent meta-analysis of parenting stress literature suggested future research should attempt to explainincreased parental stress in this population in order to promote parent resilience. Programs that emphasize the quality of parent-child interaction yield the largest effects on child and parent behavior, which could influence parent stress and resilience.

Objectives:  

Consistent with these aims, this study investigates the relationship between parenting stress, parent depression, and an early intervention program emphasizing the transactional nature of child development following an initial diagnosis of ASD.  

Methods:  

Through collaboration between a university based ASD institute and a state department of education, 60 families of young children (ages 18-36 months) are receiving services following a psychologist’s diagnosis of ASD or related developmental delay. All families participate in two home-based sessions involving consultation and training on evidence-based practices for young children with developmental differences. Half of these families (n=30) participate in an additional 12-visit series providing support guided by the Early Start Denver Model (ESDM) curriculum. At pre-test, all primary caregivers complete a Parenting Stress Index, 4^thedition – Short Form (PSI/SF) and a Center for Epidemiologic Studies Depression Scale (CES-D). All primary caregivers who participate in the two-visit series complete the PSI/SF and CES-D at the end of that series. The primary caregivers who participate in the 12-visit series (n=30) complete the PSI/SF and CES-D after all 14 visits.

When data collection is complete, initial descriptive analyses will be conducted to summarize parenting stress and depression across and within groups. Following descriptive analyses, Pearson Correlation Coefficients will be calculated to investigate the relationship between Parent Stress and Parent Depression. An ANCOVA will be conducted with post-test scores as the primary outcome variables, group status (2-visit versus 12-visit series) as the primary independent variable, and pre-test scores as the covariate. 

Results:  

Implementation

Consultation implementation at 95% fidelity across both models (Two and 12-visit). Consultants covered 90% of the ESDM curriculum; parents demonstrated 70% of strategies covered. Consultants and caregivers observed minimal-moderate levels of improvement in child behavior after two visits and moderate-significant levels of improvement following 14 visits. 

Current Sample (n=20 at pre-test)

PSI-SF at-risk threshold is85th percentile; clinical threshold is 90^thpercentile.

-          70% indicated an at-risk score; 60% indicated a clinically significant score

-          mean %ile=90.45, sd=10.45

CES-D clinical threshold is 16.

-          40% indicated a score above 16

-          mean=13.80, sd=8.93

Anticipated Results

Results regarding Pearson Correlation Coefficients and ANCOVA, and any follow-up analyses, will be presented upon completion of data collection. 

Conclusions:  

Researchers anticipate a difference in perceived parent stress and/or depression across the intervention groups. If analyses reveal a difference, then regression will be used with existing child clinical data to determine which child characteristics are associated with parent stress, parent depression, and parent responsiveness to intervention. Chi-Square may also be conducted to evaluate differences in status on stress and depression according to support series provided.