Taking Care of Their Child or Themselves? Adujsting Parent-Mediated Interventions to Answer the Various Needs of Parents Having a Toddler Suspected of ASD

Background: Parent-mediated interventions may be an interesting alternative to increase timely access to interventions, especially during the period surrounding the diagnosis assessment for ASD. Although parents are the main actors in parent-mediated interventions, few studies have examined the impact of parent-mediated interventions on parental well-being.

Objectives: This sequential explanatory mixed methods study aimed to: 1) describe the impact of a 12-week parent-mediated intervention on parental outcomes (satisfaction, sense of competence, stress), and 2) identify potential factors associated with these outcomes based on parents’ experience with the program.

Methods: Thirteen families with a toddler (12-30 month old) suspected of ASD were randomized either in the Intervention group (n=7) or the Waitlist group (n=6). Quantitative analyses of the direct impact of the intervention were conducted using the change in parental outcomes between assessment times T1 (baseline) and T2 (post-intervention for the Intervention group; second baseline for the Waitlist group) separately for the two groups. Then, a combined analysis looked at the effect of time comparing scores at baseline, post-intervention and follow-up for the combined group (Intervention and Waitlist groups merged). Qualitative interviews were conducted with a subsample of 6 families after receiving the intervention and analyzed independently by two evaluators. Finally, quantitative and qualitative data were compared for convergence and divergence, and then integrated, resulting in a more in-depth understanding of the impact of the parent-mediated intervention based on parental perspectives.

Results: Parents reported a high level of satisfaction with the intervention. Quantitative data revealed a stabilizing effect on parenting sense of competence compared to a decrease in the control group (PSOC Efficacy scale; p=.048; ES=.46). There was a trend toward reduced parental distress (PSI-SF; p=.141; ES=.48) during the intervention. Qualitative data pointed up the importance of providing: 1) early parental training about ways to stimulate their child, and 2) social support for parents in the stressful period surrounding the diagnosis. More precisely, parents were positive about being involved in stimulating their child and liked being able to take action, which gave them a sense of competence. However, they also highlighted their need for social support, especially during the stressful period surrounding the diagnosis assessment of their child. Parents felt torn between improving their skills and confidence in stimulating their child and reaching out for social support.

Conclusions: This study highlights the importance of considering the delicate balance between providing educational support to enhance parents’ sense of competence and offering targeted social support for parents of children suspected of ASD.