Parent and Child Characteristics of Families Participating in Parent-Mediated Social Skills Interventions for Autism

Background: A growing literature indicates that parent-mediated social skills interventions, such as Children’s Friendship Training (CFT; Frankel & Myatt, 2003) and the Program for the Education and Enrichment of Relational Skills (PEERS^®; Laugeson & Frankel, 2010) increase social competence and friendships among children with Autism Spectrum Disorder (ASD). In CFT and PEERS^®, parents are trained to become active agents who provide social coaching to their children during and after treatment. Despite their central role in these interventions, parents’ direct impact on their children’s treatment outcomes remains unclear. Currently, at the NYU Child Study Center, we are conducting a pilot study on outcomes for children who complete CFT and PEERS^®that involves measuring parent and child characteristics before and after intervention.

Objectives: In preparation for future investigations of treatment outcome, the current study examined baseline measures of parents’ functioning and their relationships with baseline measures of their children.

Methods: To date, we have enrolled 11 children with ASD (8 males; 7-14 year-old; M =11.9±2.3) and 11 parents (one per child; 8 mothers, 41-55 year-old; M =49.2±4.7) undergoing CFT or PEERS^®. Parents completed the Social Responsiveness Scale, Second Edition Parent Report (SRS-2-P) and the Child Behavior Checklist (CBCL), which were used to index children’s autism severity and their internalizing and externalizing symptoms of psychopathology. Parents’ autistic traits were assessed using the SRS-2 Adult Form (SRS-2-A), completed by their spouses. Each parent completed the Positive Affect Index (PAI), which assesses the quality of the parent-child relationship. Bivariate correlational analyses measured the relationships between the above parent and child measures.

Results:  Parents did not show clinically significant elevations in autistic traits, as indicated by SRS-2-A Total T-scores (range: 38 – 59, M =48.7±8.5). Total scores on the PAI varied (range: 30 – 57, M 43.1±8.8). Notably, both measures indicated a wide range of functioning. Parents’ scores on the SRS-2-A were positively correlated with their children’s scores on the SRS-2-P (r =.83, p =.04). High relationship quality measured by the PAI was negatively correlated with scores of the Total Externalizing Problems scale (r =-.85, p =.008) and related subscales (e.g., Rule-Breaking Behavior; r =-.85, p =.007) on the CBCL. There was not a significant relationship between PAI and SRS-2-P scores.

Conclusions: The association between parents’ and children’s autistic traits indicates that the poorer children’s social skills, the lower those in parents. In addition, higher quality relationships between parents and children were associated with fewer externalizing behavioral challenges in children. Given the centrality of parent-child interactions in CFT and PEERS^®, it is important to understand whether parent characteristics or parent-child relationship quality affects treatment outcomes for children who participate in parent-mediated interventions. In future investigations, we will seek to clarify these relationships and to determine whether they serve as mechanisms of therapeutic change.