Stress in Parents of Children with Risk for ASD in An Early Intervention Program

Background: Parents of children with ASD experience elevated stress in comparison to parents of typically developing children (Baker-Ericzen, Brookman-Frazee, & Stahmer, 2005). Previous research indicates that higher parent stress has been associated with lower child outcomes, increased child aberrant behaviors, and decreased child adaptive behavior (Osborne, Mchugh, Saunders, & Reed, 2008; Tomanik, Harris, & Hawkins 2007). However, minimal research has been conducted examining stress of parents of children who are newly identified with risk for ASD under the age of three (Baker-Ericzen et al., 2005).

Objectives: Our goal was to examine the association between parent stress and child outcome of children with risk for ASD in an early intervention program.

Methods: Forty-nine children between 13 and 27 months of age (M=22.4) identified with risk for ASD participated in an early intervention program. Children received an average of 9.29 treatment hours per week until age 3. Parents received an average of 21.04 hours of parent education and coaching in early intervention techniques during the course of their children’s treatment. Children received a battery of standardized assessments at intake and exit to measure progress, including the Mullen Scales of Early Learning (MSEL), the Vineland Adaptive Behavior Scales (VABS), and the Autism Diagnostic Observation Schedule (ADOS). Parents completed the Parenting Stress Index (PSI) prior to and after completing the intervention program. The PSI is a questionnaire that evaluates stress in the parent-child relationship along two scales, one scale focuses on parent-related stress (stress due to issues unrelated to the child, such as financial stress or divorce) and the other scale focuses on child-related stress (stress due to child issues, such as a disability).  The relationship between children’s scores on standardized assessments and parental stress at intake and exit were examined using Pearson correlations.

Results: To date, data for 14 children have been analyzed. Both parent-related and child-related stress were elevated at both time periods. Preliminary findings indicate that child-related stress was negatively correlated with children’s scores on the VABS at exit. Specifically, the better their children’s outcome scores on the VABS the lower the parents’ child-related stress at exit. However, child-related stress was not related to the children’s scores on the MSEL or ADOS. In addition, there was no significant relationship between parent-related stress and child outcome on any of the standardized measures.

Conclusions: Child-related parent stress is associated with some measures of child outcome after participation in early intervention. Interestingly, child-related stress levels were not correlated with child scores on the MSEL or ADOS but were correlated with the VABS, which is a parent-report measure. Therefore, child-related stress may be linked to parents’ perception of their children’s level of functioning or to unique behaviors measured by the VABS.