Abstract
Children with autism spectrum disorder (ASD) show difficulties in social communication behaviors, emotion regulation and daily living skills, and they frequently present with challenging behaviors. In parents of children with ASD, higher rates of stress and mental health problems have been reported than in parents of either typically developing children or children with other conditions. In this study, we tested whether maternal well-being changes with improved social communicative behaviors of children with ASD receiving early intervention. We examined developmental changes in 72 pre-schoolers and stress levels in their mothers (measured by the Parental Stress Inventory) before and after a 12-month community-based intervention program based on the Early Start Denver Model, a naturalistic developmental behavioral intervention targeting social communication. Multiple regression analyses showed that maternal child-related stress was predicted by changes in children's social communication behaviors (measured with the Pervasive Developmental Disorder Behavior Inventory). Gains in the early social communication behavior domain were the strongest predictor of post-intervention child-related maternal stress, surpassing adaptive behavior, language and non-verbal cognitive gains, and reduction in challenging behavior. These findings support the hypothesis that, in children with ASD, the acquisition of social communication behaviors contribute to improvements in maternal well-being.
Highlights
Autism spectrum disorder (ASD) is characterized by difficulties in social communication, patterns of restricted/repetitive behaviors and interests, and onset in early childhood [1]
As the ESDM focuses on the enhancement of child social communication behaviors, our particular interest was in the specific role of social communication development in predicting maternal stress, considering gains in language, non-verbal cognition, adaptive skills and a reduction in aberrant behaviors
Our findings indicate that improvements in social communication behaviors, for instance, improved social approach behaviors, showing positive affect behaviors, interconnecting in social plays, or imitating social cues, directly affect maternal child-related stress
Summary
Autism spectrum disorder (ASD) is characterized by difficulties in social communication, patterns of restricted/repetitive behaviors and interests, and onset in early childhood [1]. Higher rates of chronic parental stress, reduced overall well-being, increased occurrence of anxiety and depression and lower parental self-efficacy have been reported for parents of children with ASD compared to parents of either typically developing children or children with other disabilities such as Down syndrome or cerebral palsy [2,3,4,5,6]. Mothers of children with ASD often score higher on stress levels than fathers [7]. These increased rates of parental stress suggest that ASD-specific core symptoms, such as social communication difficulties and restricted and repetitive behaviors, might contribute to diminished parental well-being [8]. Comorbid conditions—such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder [9], behavioral/emotional problems [10,11,12] and anxiety or depression [13, 14]—that are often comorbid with ASD might intensify maternal stress.
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