Implementation of Early Service Interventions and Its Effects on Parent Resilience

Background:  

It is well established that parents of children with autism spectrum disorder (ASD) experience significant stress; however, far less is known about parental characteristics that may promote family resilience, defined as the ability to adapt to stressful life events and changes (Hayes and Watson 2013). A review by Bekhet and colleagues (2012) suggests that parents of children with ASD who possess indicators of resilience are more equipped to handle the stress that often accompanies caring for children with ASD. Specifically, parental self-efficacy – parents’ beliefs about their ability to parent successfully – is identified as an important predictor of resilience. Further, research demonstrates an inverse relation between parental self-efficacy and depression (Kuhn and Carter 2006), highlighting the deleterious effects of depressed mood on parents’ sense of competency. 

Objectives:  

The purpose of this study is to evaluate the impact of early intervention services for parents of children with a recent diagnosis of ASD or a related diagnosis. A primary objective of this investigation is to learn whether the enhancement of parental resilience is an outcome of early intervention services. The relation between parental self-efficacy and parental depression will also be explored. 

Methods:  

Participants include 60 families with children ages 18-36 months that are receiving support services following an ASD or related diagnosis. All families participate in two home-based sessions that include behavioral consultation and training on evidence-based practices for children with ASD. Half of these families (N = 30) participate in an additional 12-visit series providing education and support from the Early Start Denver Model (ESDM) parent training curriculum. Pre- and post-intervention measures include the Parenting Sense of Competence Scale (PSOC) and the Center for Epidemiologic Studies Depression Scale (CES-D). An Analysis of Covariance (ANCOVA) model will be used in which the post-intervention scores serve as the outcome variable, group (brief consult or ESDM) as the main independent variable, and baseline (pre-intervention) scores as the covariate. Pearson correlation coefficients will be used to determine the relation between self-efficacy and depression. 

Results:  

Preliminary data suggest that the consultants were able to implement the training model designed for each service with 95% fidelity. Additional data suggest that consultants were able to cover over 90% of the ESDM curriculum across the 12 visit model and that parents were able to demonstrate over 70% of those strategies covered within treatment sessions. Preliminary data indicate heightened levels of parent depressive symptoms pre-intervention (CES-D: M=13.80; SD=8.93) and moderate levels of parental self-efficacy (PSOC: M=74.44; SD=11.5) with an inverse relation between depression and self-efficacy (r = -0.7, p= .001). 

Conclusions:  

The current study aims to further our understanding of the factors that promote parents’ resilience following the significant life event of a child’s ASD or related diagnosis. Prior to intervention, parents endorsed elevated levels of depressive symptoms and moderate levels of self-efficacy. Subsequent analyses will examine whether a brief consultation or a longer-term intervention differentially confer benefits to parents’ self-efficacy and depressive symptoms. This information will guide future endeavors for enhancing parental well-being.