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Parent-Mediated Intervention to Improve the Perceptions of Mothers of Children with Autism Spectrum Disorder

Friday, 3 May 2013: 14:00-18:00
Banquet Hall (Kursaal Centre)
A. H. Gerber1, M. Siller1, T. Hutman2 and M. Sigman2, (1)Psychology, Hunter College of the City University of New York, New York, NY, (2)University of California, Los Angeles, Los Angeles, CA
Background: Several recent clinical trials of parent-mediated interventions for children with autism spectrum disorder (ASD) have demonstrated improvements in responsive parental behaviors, child communication and autism symptom severity (Kasari et al., 2010; Aldred, et al, 2004; Siller et. al, 2012; Green et al, 2010; Carter et al., 2011). Little is known, however, about the effects of these interventions on the parents’ cognitions and emotions.

Objectives: The current study is a randomized clinical trial of Focused Playtime Intervention (FPI), a parent-mediated intervention that has been shown to effectively improve responsive parental behaviors and, to some extent, child communication (Siller et al., 2012). Treatment effects on parent cognitions and emotions were evaluated using a battery of parent-report questionnaires.

Methods: The sample included 70 mothers of children with ASD. Children ranged in age from 32-82 months (M=57.1 months, SD=12.3) and showed limited expressive language skills (M=15.9 months, SD=9.0) on the Mullen Scales of Early Learning (MSEL; Mullen, 1995). Upon intake, families were randomly assigned to either the control or experimental group. Parents in both groups participated in four educational sessions on advocating effectively for a young child with ASD. In addition, parents and children assigned to the experimental group were invited to participate in 12 in-home sessions of FPI. Maternal cognitions and emotions were evaluated before and after the 4-month treatment period, as well as 12 months thereafter, using three questionnaire measures: (1) The Questionnaire on Resources and Stress (QRS; Konstantareas, Homatidis & Plowright, 1992); (2) the Maternal Perception of Child Attachment questionnaire (MPCA; Hoppes & Harris, 1990); and (3) the Concepts of Development Questionnaire (CODQ; Sameroff & Feil, 1985). Over the course of the study, we observed a fairly low attrition rate of 11%. Questionnaire data, however, were missing for 8%, 20%, and 40% of the participants at baseline, exit, and follow-up, respectively.

Results: Residual gain scores were calculated to represent change on parent measures between the three time points (intake, exit, and follow up). Analysis indicated that between intake and exit, mothers in the experimental group (M = 0.10, SE = 0.07) showed larger gains in perceived child attachment (MPCA) than mothers in the control group (M = -0.13, SE = 0.07), t(51) = 2.36, p < .05. Mothers in the experimental group (M = 0.09, SE = 0.06) also demonstrated greater gains in their understanding of child development (Perspectivistic subscale of CODQ) than mothers in the control group (M = -0.07, SE = 0.04), between intake and follow up, t(29.20) = 2.12, p < .05. Treatment effects on parent-reported stress (QRS) were not significant.

Conclusions: Results from this study reveal significant treatment gains in mothers’ perception of child attachment and understanding of child development, but not in the parents’ level of reported stress. One limitation of the current study is the modest amount of missing data. To address this limitation, future analyses will utilize multiple imputation to increase statistical power and prevent erroneous conclusions (Enders, 2010).

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