Compassion Meditation for Parents: Effects on Stress and Perceived ASD Severity

Background:

Parents of children with Autism Spectrum Disorder (ASD), who are often required to be fully involved in their children’s intervention, have higher incidence of depressive symptoms and stress than parents of typically developing children (Jeans et al., 2013). Whereas the practice of mindfulness and compassion meditation is reportedly associated with stress reduction in several populations (Cosley et al, 2010), there are very few studies describing mindfulness based interventions for caregivers of individuals with ASD (Bazzano et al., 2013, Dickens et al., 2014) and none to our knowledge using compassion meditation.

Objectives:

The goal of this research is to pilot-test Cognitively Based Compassion Training (CBCT), a mindfulness and compassion meditation protocol developed at Emory University and empirically validated in other populations, with parents of children with ASD in order to reduce stress in these parents and, in turn, impact the children’s outcomes.

Methods:

Participants included 9 caregivers of children with ASD (age in years M±SD = 43.8 ±5.5; 8 females) recruited at the Marcus Autism Center in Atlanta, GA. Participants received CBCT over the course of 8-10 weeks and completed several measures before and after the training, with a follow-up at 2 months: perceived severity of the child’s symptoms (Aberrant Behavior Checklist or ABC-Irritability Scale), stress and acceptance (Parenting Stress Index or PSI/SF, Perceived Stress Scale or PSS, and Acceptance and Action Questionnaire or AAQ), empathy and compassion (Interpersonal Reactivity Index  or IRI), behavioral flexibility (Mindful Attention Awareness Scale  or MAAS, and  Behavior Rating Inventory of Executive Function  or BRIEF-A), and parent-child relationship (Parenting Sense of Competence Scale or PSS).

Results:

Paired t-tests were utilized to evaluate pre-post changes in scores at the 0.05 significance level. Findings included a significant decrease in perceived severity of the child’s symptoms as measured by the ABC-I (Time 1 M±SD = 11.7±8.06; Time 2 M±SD = 7.7±8.2) and a significant decrease in parent stress according to the total stress PSI scale (Time 1 M±SD = 94±28.35; Time 2 M±SD = 76.2±29.6) and the PSS scale (Time 1 M±SD = 21.7±3.09; Time 2 M±SD = 13.1±4.39). There was a significant increase in behavior flexibility according to the Behavior Regulation Index of the BRIEF-A, Inhibit scale (Time 1 M±SD = 11.4±1.26; Time 2 M±SD = 9±1.62) and Shift scale (Time 1 M±SD = 10±0.86; Time 2 M±SD = 7±1.29). Marginally significant differences were found in the direction expected in the Parenting Sense of Competence Scale (Time 1 M±SD = 70.1±9.46; Time 2 M±SD = 82.4±11.65; p=.05) and no significant differences in the three measures related to acceptance (AAQ), empathy (IRI) and mindfulness (MAAS) (n.s.). A second set of analyses including repeated measures analysis of variance for the only four participants that completed follow-up measures suggest that gains were maintained in the PSI, PSS and BRIEF scales.

Conclusions:

Taken together these promising results suggest that CBCT is a feasible training for parents of children with ASD, with potential benefits on their stress and their perceived children’s severity. A randomized controlled trial should test its efficacy under controlled conditions.