A Pilot Study on the Impact of Group-Delivered Parent Training on Parental Self-Efficacy and Stress

Background: Parent-implemented, naturalistic behavioral intervention using a group-based parent training format represents a unique and efficient service-delivery model. Research suggests these interventions positively impact the social, communication, and language skills of young children with autism spectrum disorder (ASD; Hardan et al., 2015; Laugeson et al., 2016; Minjarez et al., 2010). Given their primary role, parent factors may influence child changes in parent-mediated approaches. Though researchers have studied family empowerment and parental stress outcomes in group parent-implemented models (Minjarez et al., 2013), parental stress has been considered more prominently in the broader parent training literature and with inconclusive results. Another parent factor warranting investigation is parental self-efficacy (Steiner et al., 2012), an underrepresented construct in the ASD parent training literature. Changes in parental self-efficacy following group-delivered parent training programs may be integral to understanding variability in proximal and maintained treatment outcomes and may be linked to parental stress. As such, it is valuable to study the impact of group parent training on parental self-efficacy.

Objectives: This study highlights the understudied construct of self-efficacy in the context of group-delivered, parent-mediated interventions for young children with ASD by examining changes in parental self-efficacy and whether such changes are related to changes in parent stress.

Methods: As part of an ongoing clinical study, we are enrolling 30 total parents of children with ASD under the age of 5, with 15 parent-child dyads in each intervention group: (1) Pivotal Response Treatment (PRT) and (2) Preschool PEERS, two empirically supported, group-delivered parent training programs targeting social communication skills. Parents are asked to report on their levels of parenting self-efficacy (Early Intervention Parenting Self-Efficacy Scale, EIPSES) and stress (PSI-Short Form 4 or Caregiver Strain Questionnaire) before and after their participation in their respective intervention. At present, we have collected completed preliminary pre- and post-treatment self-efficacy and stress data on seven participants. Table 1 displays the data for our preliminary descriptive analysis.

Results: Based on our pilot sample, families both increased and decreased in self-efficacy and stress. Three of seven parents reported increases in self-efficacy (average increase of 0.33 points on the EIPSES), with two of those parents also reporting concomitant decreases in stress levels, and one of them reporting little change. The remaining four parents reported decreases in parental self-efficacy (average decrease of 0.58 points on the EIPSES), with three of those parents reporting increases in stress levels and one reporting a decrease.

Conclusions: Despitethe overall mixed results suggested by these preliminary findings, there may be an emerging pattern of negative relationships between changes in parental self-efficacy and changes in parental stress, whereby increases in self-efficacy are accompanied by decreases in stress and vice versa. Importantly, variability in our small dataset is prominent, with some families reporting less self-efficacy and more stress at post. As we continue to enroll families in our ongoing study, a larger sample will allow us to inferentially examine the mechanism of intervention changes in parental self-efficacy and stress across and between the two intervention groups.