Parenting stress in caregiver-mediated interventions for toddlers with autism: An application of quantile regression mixed models.
Andrew Schlink, Justin Williams, Maria Pizzano and 2 others
PMID 34797038WHAT IT FOUND
Both caregiver training programs lowered stress about child behaviors for most parents.
However, parents in the hands-on coaching group saw their own personal stress rise after support ended, while those in the education group saw it fall. This suggests ongoing support is needed to prevent burnout.
Key findings
01Parents in both the JASPER coaching and PEI education groups significantly reduced their stress related to their child's behaviors, with no statistical difference in the rate of reduction between the two groups.
02From entry to the 3-month follow-up, parents in the JASPER group generally saw an increase in their own personal stress scores, while parents in the PEI group saw a decrease.
03The increase in personal stress was most pronounced in the JASPER group for parents who started with very low stress levels, whereas parents with very high baseline stress did not show a significant treatment effect difference.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (86 participants), which limited the statistical power of the analysis. The study was a secondary analysis of an existing trial, so it was not originally designed to test these specific questions about stress quantiles. The interventions were delivered within the context of a separate, intensive 10-week early intervention program (30 hours/week), which may not reflect typical community practice where such intensive concurrent therapy is unavailable. Attrition occurred, though intent-to-treat analysis was used.
The easy way to misread this
Do not conclude that parent education (PEI) is superior to hands-on coaching (JASPER) for improving child outcomes. The study only measured parenting stress, not child progress. Furthermore, both interventions successfully reduced stress about the child's behavior. The finding that JASPER parents' personal stress increased later is a caution about the need for ongoing support, not evidence that the coaching itself failed to help the child.