Mindfulness for Parents of Children With Autism Spectrum Disorder Autism Spectrum Disorder
Condition: Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
Study type: Interventional

Summary: 
      The current study examines the efficacy of Mindfulness-Based Stress Reduction (MBSR) to
      reduce parenting stress, lessen parental reactivity and negativity, and decrease child
      externalizing behaviors among families of children with Autism Spectrum Disorder (ASD). The
      design is a randomized controlled trial of 138 families of preschool-aged children with ASD.
      Parents of children with ASD will be randomized to MBSR or to a Psychoeducational (PE)
      support control group matched for clinical contact and dosage (see details on interventions
      below). Families will participate in laboratory assessments at baseline and immediately
      post-treatment, as well as at 6 months and 12 months post-treatment. Measures include
      standardized and validated parent and teacher questionnaires, gold-standard psychological
      assessments, and observational and interview ratings.
    

Detailed description: 
      Families of children with Autism Spectrum Disorder (ASD) experience heightened risk due to
      elevated rates of clinically-significant parenting stress and child externalizing behavior
      problems. Parenting stress is a robust predictor of subsequent externalizing challenges in
      children with ASD. Nonetheless, few evidenced-based treatments exist for reducing parenting
      stress in these families. The mechanisms through which parenting stress influence child
      externalizing problems are also unclear, although preliminary evidence suggests the potential
      role of negative parenting behaviors. This study comprehensively addresses these
      considerations by testing the efficacy of Mindfulness-Based Stress Reduction (MBSR) as an
      intervention to reduce parenting stress, lessen parental reactivity and negativity, and
      decrease child externalizing behaviors.

      MBSR is particularly well-suited for parents of children with ASD given the intervention
      emphasis on teaching participants to manage reactivity in the context of persistent stress.
      However, the efficacy of MBSR has yet to be established for this population. The present
      investigation extends preliminary investigations of mindfulness approaches by: 1) conducting
      a stringent test of MSBR using an active psychoeducational (PE) control, 2) developing
      population-specific content and testing the efficacy of MSBR for parents of children with
      ASD, 3) utilizing a highly diverse, underserved community-based sample, 4) examining the
      mechanisms underlying observed treatment effects, and 5) employing multi-method longitudinal
      measurement from multiple sources in order to examine immediate and long-term treatment
      effects.

      The current study is a randomized controlled trial of 138 families of preschool-aged children
      with ASD. Parents will be randomized to MBSR or to a PE support group matched for clinical
      contact and dosage. Families will participate in laboratory assessments at baseline and
      immediately post-treatment, as well as at 6 months and 12 months post-treatment. Measures
      include standardized and validated parent and teacher questionnaires, gold-standard
      psychological assessments, and observational and interview ratings.

      The MBSR intervention includes eight weekly 2.5-hour group sessions, a day-long (6hr)
      meditation retreat on the weekend during week six, 45 minutes of daily home practice guided
      by instructional audio CDs (portable CD players will be provided when necessary), and an MBSR
      parent workbook. Formal mindfulness exercises aim to increase the capacity for mindfulness
      (present-moment awareness with a compassionate, non-judgmental stance) and include a body
      scan, mindful yoga, and sitting meditation. Participants are also taught to practice
      mindfulness informally in everyday activities. In session, didactic instruction on stress
      physiology and using mindfulness for coping with stress in daily life is provided.
      Participants practice formal mindfulness exercises, break into dyads to discuss their daily
      homework practice, and meet as a larger group to ask questions related to the practice of
      mindfulness in everyday life.

      In order to provide a rigorous test of the contributions of mindfulness techniques, the
      current investigation will control for therapeutic effects associated with clinician contact
      and group support by comparing MBSR to a PE support condition matched for dosage. The PE
      condition also consists of 8-weekly 2.5-hour sessions, a day-long (6hr) Family Resource Fair
      during week six (wherein families will attend talks by professionals, explore available local
      resources, and meet with service providers), daily homework that includes monitoring progress
      on goals identified at the end of each session, and a workbook for parents of children with
      special needs that provides parents with information regarding their child's development,
      disability, and associated considerations.

      Establishing an efficacious stress reduction intervention to target mechanisms linking
      parenting stress, negative parenting behaviors, and child externalizing problems will advance
      clinical science and optimize outcomes for children with ASD and their families.
    

Intervention name(s): Mindfulness-Based Stress Reduction (MSBR); Psychoeducational Support Group (PE)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): MBSR includes eight weekly 2.5-hour group sessions, a day-long (6hr) meditation retreat on the weekend during week six, 45 minutes of daily home practice guided by instructional audio CDs, and an MBSR parent workbook. Formal mindfulness exercises aim to increase the capacity for mindfulness and include a body scan, mindful yoga, and sitting meditation. Participants are also taught to practice mindfulness informally in everyday activities. In session, didactic instruction on stress physiology and using mindfulness for coping with stress in daily life is provided. Participants practice formal mindfulness exercises, break into dyads to discuss their daily homework practice, and meet as a larger group to ask questions related to the practice of mindfulness in everyday life.; The PE consists of 8-weekly 2.5-hour sessions, a day-long (6hr) Family Resource Fair during week six, daily homework that includes monitoring progress on goals identified at the end of each session, and a workbook for parents of children with special needs that provides parents with information regarding their child's development, disability, and associated considerations. Weekly topics for discussion include Preparing for Individualized Education Plan (IEP) meetings, Communicating with Teachers, Advocacy, Sibling Issues, and Community Resources.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The proposed study is a randomized controlled trial of 138 families that will be conducted in three cohorts. Each cohort will involve a recruitment phase of 46 participants. Within each cohort parents will be randomly assigned to the MBSR (N=23) or PE group (N=23), and the groups will run concurrently.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment