Posted 05.26.2020 | by AMRA
About 2% of American children are diagnosed with autism spectrum disorder. Parents of children with autism must navigate their child’s impairments in social relatedness, communication, and cognition, as well as their behavioral difficulties. Therapists often train parents to engage in play and joint activities with their children to help foster language, social, and cognitive skills. Parents, however, are often distressed by their child’s condition, limiting their effectiveness in optimally fostering their child’s development.
Weitlauf et al. [Pediatrics] tested whether Mindfulness Based Stress Reduction (MBSR), when combined with a program that coaches parents on how to help their child with autism, could effectively reduce parental distress.
The researchers randomly assigned 61 parents (average age = 33 years; 89% female; 90% Caucasian) of preschool children diagnosed with autism to a 12-week training in a Parent-delivered Early Start Denver Model (PESDM) intervention or PEDSM plus MBSR. PESDM consisted of 12 hour-long weekly clinic-based sessions facilitated by therapists. Parents were coached on how to interact with their children to foster skill development.
Parents in the PESDM+MBSR group met with a mindfulness trainer for six additional hour-long individual MBSR sessions. Mindfulness training sessions focused on cultivating present-moment awareness, gratitude, and stress management skills.
Parents were assessed at baseline, mid-intervention, intervention end, and at 1, 3, and 6 months follow-up on measures of parental stress, depression, anxiety, life satisfaction, and mindfulness (using the Five Facet Mindfulness Questionnaire). Children were assessed on a number of dimensions including parental ratings of the severity of their behavioral problems.
The results showed that parents in both study groups reported significantly decreased parental stress, depression, and anxiety during the study intervention period. During the 6-month follow-up period, improvements in anxiety remained for both groups. Parental stress and depressive symptoms gradually increased towards, but did not return to, baseline levels.
Mindfulness levels increased in PESDM+MBSR and decreased in PESDM during the active intervention period. This increase in mindfulness was significant only for mothers.
During the study intervention period, the PESDM+MBSR group had significantly greater decreases on the parental distress scale and the parent-child dysfunctional interactions scale than PESDM. The parent-child dysfunctional interaction scale measures parents’ feelings of disappointment, rejection by, or alienation from the child reflecting a lack of proper bonding.
Regardless of treatment group, parents of children with the most behavioral difficulties were the most distressed at baseline, and showed significantly greater decreases in distress with treatment.
The study shows that training parents of children with autism to engage in a low-intensity intervention designed to enhance their children’s language, social, and cognitive skills reduces parental distress, depression, and anxiety. Additionally, an add-on MBSR training increases mindfulness in mothers and further reduces parental distress and parental feelings of alienation, rejection, and disappointment. The study is limited by the unequal time commitment required in each of the two study groups and the minimal level of training of the MBSR clinicians.
Weitlauf, A. S., Broderick, N., Stainbrook, J. A., Taylor, J. L., Herrington, C. G., Nicholson, A. G., . . . Warren, Z. E. (2020). Mindfulness-Based stress reduction for parents implementing early intervention for autism: An RCT. Pediatrics.