Mindfulness-Based Stress Reduction for Parents Implementing Early Intervention for Autism: An RCT

Abstract

BACKGROUND AND OBJECTIVES: Systems of care emphasize parent-delivered intervention for children with autism spectrum disorder (ASD). Meanwhile, multiple studies document psychological distress within these parents. This pilot longitudinal randomized controlled trial compared the parent-implemented Early Start Denver Model (P-ESDM) to P-ESDM plus mindfulnessbased stress reduction (MBSR) for parents. We evaluated changes in parent functioning during active treatment and at follow-up.METHODS: Participants included children (,36 months old) with autism spectrum disorder and caregivers. Participants were randomly assigned to P-ESDM only (n = 31) or P-ESDM plus MBSR (n = 30). Data were collected at baseline, midtreatment, the end of treatment, and 1, 3, and 6 months posttreatment. Multilevel models with discontinuous slopes were used to test for group differences in outcome changes over time. RESULTS: Both groups improved during active treatment in all subdomains of parent stress (b = 21.42, 21.25, 20.92; P , 0.001), depressive symptoms, and anxiety symptoms (b = 20.62 and 20.78, respectively; P , 0.05). Parents who received MBSR had greater improvements than those receiving P-ESDM only in parental distress and parent-child dysfunctional interactions (b = 21.91 and 21.38, respectively; P , 0.01). Groups differed in change in mindfulness during treatment (b = 3.15; P , .05), with P-ESDM plus MBSR increasing and P-ESDM declining. Treatment group did not significantly predict change in depressive symptoms, anxiety symptoms, or life satisfaction. Differences emerged on the basis of parent sex, child age, and child behavior problems.CONCLUSIONS: Results suggest that manualized, low-intensity stress-reduction strategies may have long-term impacts on parent stress. Limitations and future directions are described.WHAT'S KNOWN ON THIS SUBJECT: Parents play an integral role in early intervention for young children with autism spectrum disorder. They also report high levels of stress and psychopathology. Training in mindfulness practice may help parents of older children with autism spectrum disorder.WHAT THIS STUDY ADDS: This pilot randomized controlled trial compares the functioning of parents who participated in child-focused, parent-mediated behavioral intervention alone to that of parents who also received stress-reduction training.

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