Using Mindfulness Based Stress Reduction to Reduce Caregiver Distress As Part of Behavioral Intervention for Young Children with ASD

Background:  Caregivers of children with ASD report elevated levels of distress (Carter et al., 2009; Davis et al., 2008) that can negatively impact parental health as well as the potential effectiveness of early interventions (Gallagher et al., 2009; Osborne et al., 2008). Therefore, it may be critical for early intervention services to ameliorate clinically significant caregiver distress as part of early intervention itself.

Objectives:  This preliminary data is drawn from the initial phase a longitudinal randomized control trial comparing the effectiveness of an empirically supported parent-coaching intervention program, the Parent-implemented Early Start Denver Model (P-ESDM; n = 14), to a P-ESDM intervention enhanced with Mindfulness Based Stress Reduction for caregivers (MBSR; n = 10). Our objective was to evaluate differences in caregiver mental health and parenting stress across groups.

Methods: Participants included the caregivers of young children (m_age = 1.57 years, sd = .39) recently diagnosed with autism spectrum disorder. Children’s ADOS-2 scores indicated moderate-to-high levels of autism symptoms (m_ADOS-2 = 21.67, sd = 4.44) and significant developmental delays on the Mullen Scales of Early Learning (m_MSEL= 53.43, sd = 5.70). Participating mothers (n = 20) and fathers (n = 4) were randomly assigned to receive 12 weekly sessions of P-ESDM with and without 6 concurrent sessions of MBSR. Data was gathered at treatment initiation and conclusion.

Results:  At baseline, both groups reported statistically similar levels of depression (m_PESDM = 10.54, sd = 6.97; m_MBSR = 10.30, sd = 9.35), anxiety (m_PESDM = 7.92, sd = 6.61; m_MBSR = 9.50, sd = 6.64), and overall parenting stress (m_PESDM = 94.70, sd = 15.00; m_MBSR = 87.91, sd = 10.85) as measured by the Centers for Epidemiologic Studies – Depression scale, Beck Anxiety Inventory, and the Parenting Stress Inventory. Although within group changes were not significant, the entire sample of caregivers showed trends toward decreased depression symptoms (m_T1CESD = 10.44, sd = 7.89; m_T2CESD = 7.96, sd = 3.15; t = 2.061, p = .051). Group differences emerged in self-reported anxiety at post-treatment, with caregivers who received MBSR reporting significantly lower anxiety levels than caregivers who did not (m_PESDM = 8.46, sd = 8.03; m_MBSR = 2.10, sd = 1.96; t = 2.44, p < .05). Caregivers who received MBSR also reported significantly lower levels of parenting stress (m_PESDM = 87.91, sd = 10.85; m_MBSR= 73.63, sd = 16.12; t = 2.32, p < .05).

Conclusions:  Promising preliminary evidence suggests that MBSR reduced anxiety and parenting stress across the course of treatment. This provides initial support for directly addressing caregiver distress as part of treatment for young children with ASD.