Mindfulness-Based Stress Reduction for Parents Implementing Early Intervention for Autism: An RCT
BACKGROUND AND OBJECTIVES: Systems of care emphasize parent-delivered intervention for children abstract with autism spectrum disorder (ASD). Meanwhile, multiple studies document psychological distress within these parents. This pilot longitudinal randomized controlled trial compared the parent-implemented Early Start Denver Model (P-ESDM) to P-ESDM plus mindfulness-based stress reduction (MBSR) for parents. We evaluated changes in parent functioning
during active treatment and at follow-up.
METHODS: Participants included children (,36 months old) with autism spectrum disorder and
caregivers. Participants were randomly assigned to P-ESDM only (n = 31) or P-ESDM plus
MBSR (n = 30). Data were collected at baseline, midtreatment, the end of treatment, and 1, 3,
and 6 months posttreatment. Multilevel models with discontinuous slopes were used to test
for group differences in outcome changes over time.
RESULTS: Both groups improved during active treatment in all subdomains of parent stress
(b = 21.42, 21.25, 20.92; P , 0.001), depressive symptoms, and anxiety symptoms
(b = 20.62 and 20.78, respectively; P , 0.05). Parents who received MBSR had greater
improvements than those receiving P-ESDM only in parental distress and parent-child
dysfunctional interactions (b = 21.91 and 21.38, respectively; P , 0.01). Groups differed
in change in mindfulness during treatment (b = 3.15; P , .05), with P-ESDM plus MBSR
increasing and P-ESDM declining. Treatment group did not significantly predict change in
depressive symptoms, anxiety symptoms, or life satisfaction. Differences emerged on the
basis of parent sex, child age, and child behavior problems.
CONCLUSIONS: Results suggest that manualized, low-intensity stress-reduction strategies may
have long-term impacts on parent stress. Limitations and future directions are described.