"and Yet, I Still Hope": Parenting Self-Efficacy in ASD

Background: Children with ASD are often involved in multidisciplinary, complex therapy programs, requiring significant caregiver management, participation, and strain (Ruble & McGrew, 2007; Kandolkar & Kenchappanavar, 2014). Parenting self-efficacy, i.e. the expectations caregivers have about their abilities to successfully parent their children, has previously been shown to predict a parent’s ability to cope with the unique challenges of raising a child with ASD (Pastor-Cerezuela et al., 2016; Kuhn & Carter, 2006). High parental self-efficacy has been shown to mediate parental stress (Bayat, 2007). Despite a recent focus on family-centered care and parental involvement in therapy for children with ASD, little research has investigated the impact of various components of a child’s therapy programming on parental ratings of confidence and self-efficacy.

Objectives: We aim to assess the effects of intervention intensity, parental therapy involvement, and parent training on ratings of parenting self-efficacy. This study seeks to answer two questions: (1) To what extent do intervention-level factors (e.g. degree of parental involvement in intervention, training from professionals, intervention frequency, number of different interventions) modulate autism-specific parenting self-efficacy?; (2) Does perceived level of caregiving burden mediate the predictive power of these intervention-level factors on parental self-efficacy ratings?

Methods: Parents of children with ASD (N=439) across 47 states completed an online questionnaire on parenting self-efficacy for autism (PSEa). The survey was designed to capture parental confidence in advocating for their child with ASD, confidence in navigating the complexities of autism intervention, and perceived level of social and financial strain associated with raising their child. It also captured basic demographic information and details of intervention frequency, modality, and number and type of clinical interventions.

Results: We used linear regression with PSEa as the outcomes measure. Result show that time since diagnosis, parental rating of involvement across all therapies, and parental rating of satisfaction with training significantly predict PSEa. We also grouped participants by high vs. low parental strain and found that for individuals who rated the strain of raising their child as low, parental involvement in therapy significantly predicted 32.3% of the variance in PSEa and parental satisfaction with intervention training significantly predicted 30.3% of the variance in PSEa. Conversely, among parents with a high rating of strain, parental involvement predicted only 18.7% of PSEa ratings and training satisfaction did not significantly predict PSEa. PSEa was not significantly predicted by number of therapies, total number of therapy hours per week, severity of child’s ASD symptoms, or child language level.

Conclusions: Data collected from 439 caregivers of children with ASD indicate that parental self-efficacy can be improved through parental involvement and positive training experiences, as long as perceived burden is low. However, when parents indicate high perceived burden, practitioners may need to prioritize working with families to counsel, refer to other professionals, and engage community resources in order to decrease burden and enable parents to derive maximal benefit from training and involvement. Interestingly, these effects seem to be independent of intensity of intervention, severity of child’s ASD symptoms, or child language level.