- Toddlerhood (13-35 months)
AbstractAn estimated 1 in 68 children in the United States have an autism spectrum disorder (ASD; CDC, 2014). Caregivers of children with ASD report higher levels of depression and distress than caregivers of typically developing children as well as children with other developmental disabilities (Carter et al., 2009). Recent findings suggest that this distress may be very common; it can have significant negative effects not only on parental mental and physical health, but also on the potential effectiveness of early intervention strategies (Osborne et al., 2008). Given the importance of early intervention to improve child functioning and the fact that parents often play significant roles in facilitating treatment, it may be critical to design and implement early intervention programs that directly address and treat parental distress. The proposed work tests a novel treatment paradigm that blends Mindfulness Based Stress Reduction (MBSR) with an empirically supported and manualized parent training program (Parent-Implemented Early Start Denver Model [P-ESDM]). We hypothesize that directly treating parental distress, while simultaneously providing evidence-based parent training, may greatly enhance child-focused intervention and provide benefits that resonate across family and service systems, not only during this early period but potentially across family lifespan. We have two specific aims: 1) To compare the effectiveness of P-ESDM versus P-ESDM + MBSR in enhancing parental health, and 2) To examine the effectiveness of P-ESDM versus P-ESDM + MBSR in enhancing child and family related outcomes. We will recruit and randomly assign 60 families to 12 weeks of P-ESDM (n=30) or PESDM + MBSR treatment (n=30). Parent and child measures will be completed across six assessment periods (i.e., baseline, 6 weeks of intervention, end of 12 week intervention, and 1, 3, and 6 months post-intervention). We will test markers of enhanced parental and family health, child development, and service-related outcomes. To our knowledge, this will be the first test of a potentially transformational early intervention paradigm: directly treating parental distress as a fundamental component of evidence-based treatment. Documenting the effective treatment of caregiver distress and the important collateral impact of such treatment would represent an innovative shift in our understanding of effective comprehensive early intervention programming for young children with ASD and their families. This work could impact the way parents, providers, and early intervention systems conceptualize intervention planning on a large scale. It may demonstrate the need for enhanced early intervention programming that incorporates services focused not only on child skill development, but also on broader factors that promote caregiver and family well-being as essential components of treatment.
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