A New Way to Help Parents? Exploring the Impact of School-Based Interventions on Parenting Outcomes

Background: Increased levels of parenting stress are well documented in parents of children with neurodevelopmental disorders in comparison to parents of typically developing children, with parents of children with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) reporting the highest scores (Craig et al., 2016a). Parenting stress impacts individual beliefs and behaviors (e.g., parent self-efficacy) as well as the family system and can lead to diminished outcomes on child-focused therapy. In turn, child behavior has been shown to influence parenting stress and practices. Executive dysfunction, or difficulties with behavioral, emotional or cognitive regulation, has been suggested to serve as an endophenotype in neurodevelopmental disorders (Craig et al., 2016b), and may play an important underlying role in parenting stress and self-efficacy. Although not the primary target of treatment, analyzing the secondary impact of a school-based intervention on parents can help examine family impact, which in turn can lead to greater maintenance of child skills.

Objectives: Determine the impact of a school-based intervention on parenting strain and self-efficacy and explore moderators of change.

Methods: Participants included 148 parents (79.1% mothers) of children diagnosed with ASD (n = 50) or ADHD (n = 98) from Title 1 eligible schools in Washington, D.C. and northern Virginia. Children were randomly assigned to either Unstuck and On-Target or Parents and Teachers Supporting Students. Parent strain (Caregiver Strain Questionnaire-Short Form 7 (CSQ-7; Brannan et al., 2012)), parenting self-efficacy (subscale from Family Empowerment Scale (FES; Singh et al., 1995)), and child executive dysfunction (two subscales from the Behavior Rating Inventory for Executive Function (BRIEF; Gioia et al., 2000) were measured at pre, post, and follow-up.

Results: There was a significant decrease in subjective parenting strain from pre to post-treatment (t(91) = 3.08, p = .003) and maintained to follow-up (t(73) = 2.10, p = .039). A significant decrease in objective parenting strain was noted from pre- to post-treatment (t(90) = 3.15, p = .002), but effects did not extend to follow-up (t(72) = 2.10, p = .265). Although parent self-efficacy increased from pre- to post-treatment, it was not a significant change (t(85) = -.80, p = .425). After controlling for baseline levels of parenting strain and child executive dysfunction, only change in metacognition significantly predicted change in subjective parenting strain (β = .413, p = .002). Changes in metacognition (β = .276, p = .027) and not behavioral regulation (β = .189, p = .094) significantly predicted change in objective parenting strain.

Conclusions: The current study builds on the encouraging findings in relation to both treatments demonstrating positive changes in child executive functioning and behavioral flexibility. Results demonstrate significant changes in parenting strain and not parenting self-efficacy as a consequence of participating in these school-based treatments. Interestingly, only change in metacognition, or increases in child’s ability to plan, organize, and initiate tasks) significantly predicted change in both subjective and objective strain. Neither changes in classroom observation nor number of parent training sessions attended impacted change in parenting strain or self-efficacy.