Brief Report: Impact of Challenging Behavior on Parenting Stress in Mothers and Fathers of Children with Autism Spectrum Disorders. M. Argumedes, M. J. Lanovaz, & S. Larivee (2018)
Background
Raising a child with ASD is associated with higher levels of parenting stress when compared to parents of children without ASD. Children with ASD who exhibit challenging behaviors (e.g., hitting, disruptive behavior, self-injury) often have parents that report even higher levels of stress. Although the relationship between parenting stress and challenging behavior has been repeatedly reported as a problem, there has been limited research looking at whether reducing challenging behavior can improve parent stress.
Who was involved?
This study included families with a child with ASD who was less than 12 years old and presented at least one moderate or severe challenging behavior at home. Families were divided into groups at random to receive either an 8-week family-centered support intervention or a 3-hour one-to-one parent education session focused on challenging behaviors. The family-centered support was based on an adaptation of Prevent-Teach-Reinforce, which involves parents collaborating with a behavior consultant to assess needs, implement strategies, and teach more productive skills. The parent education presented parents with information on how to take data, understand why a behavior occurs, choose an appropriate way to reduce problem behavior, and select positive skills to target. However, this second group did not have ongoing consultation and support from a behavioral consultant. All sessions were held in the family’s home. The researchers looked at how severe ASD symptoms were in the child, the frequency and severity of challenging behaviors, and parenting stress before treatment began. Challenging behaviors and parenting stress were then also assessed after treatment and at a 3-month follow-up.
What was the outcome?
Similar to what other research has found, more severe ASD symptoms and challenging behavior were associated with higher levels of parental stress. Importantly, when challenging behavior decreased, the researchers found there were also decreases in parent stress. Although both interventions reduced parenting stress, the 8-week family-centered support resulted in larger reductions in parenting stress compared to a 3-hour educational session on challenging behavior. Three months after the treatment had ended, parents maintained lower levels of stress similar to levels just after treatment had ended.
What are the strengths and limitations of the study?
Strengths: This is the first study to directly compare two parent interventions to manage challenging behavior and to examine the effects on parenting stress. Both interventions took place in the family’s home, meaning the support was provided within the natural situations in which challenges occur.
Limitations: Since the amount of time each group received treatment was different between the two interventions, it is hard to know whether the more effective 8-week program was due to the amount of time spent in intervention or certain parts of the treatment itself. Also, access to a behavioral expert to work collaboratively with is a much different resource than just hearing information about how to do some of the steps.
What are the implications?
The results indicate that stress in parents of children with ASD is affected by challenging behavior and that reducing challenging behavior can help parents be less stressed. Although information provided in a brief education session can be helpful to parents, if time and resources allow it is best to have an ongoing relationship with a behavioral consultant given the larger stress reduction with such a support.
