Examining the Links Between Challenging Behaviors in Youth with ASD and Parental Stress, Mental Health, and Involvement: Applying an Adaptation of the Family Stress Model to Families of Youth with ASD.
Hillary K Schiltz, Alana J McVey, Brooke Magnus and 8 others
PMID 29275509WHAT IT FOUND
Adolescents' challenging behaviors tracked with higher parenting stress, and stress related to more depressive symptoms and lower parent involvement.
Anxiety showed a weaker link. Parents' anxiety and depression did not improve overall after a parent-assisted social skills program.
Key findings
01In families of adolescents with ASD, more challenging adolescent behaviors were linked to higher parenting stress, higher stress was linked to more parental depressive symptoms, and those symptoms were linked to lower parental involvement.
02Parental anxious symptoms did not show the same link to lower involvement; parenting stress alone was linked to lower involvement in the anxiety model.
03Across PEERS and waitlist, parents' depressive and anxious symptoms did not show clear improvement over time; only a marginal within-group decrease in depressive symptoms occurred.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a follow-up analysis of a randomized trial, not a trial designed to test whether PEERS works for parents. The main pathway analyses used only pre-intervention data, so they cannot show that challenging behaviors caused stress or that stress caused lower involvement. All key variables were parent self-report, and some measures had not been validated in families of youth with ASD. Parents' average anxiety and depression scores were low, so the findings may not apply to parents with more severe symptoms. The sample had limited racial, ethnic, and socioeconomic diversity, and it included only families able to take part in a 14-week program. The study did not test which specific challenging behaviors mattered most, nor did it measure the quality of parental involvement. There was no treatment-as-usual or comparison intervention, so any changes cannot be attributed specifically to PEERS. Change analyses included only parents with complete pretest and posttest data.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read PEERS as proven to improve parents' mental health. The overall change over time did not differ significantly between PEERS and waitlist, and the only within-group depression change was marginal.