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Improving maternal mental health after a child 's diagnosis of autism spectrum disorder : results from a randomized clinical trial . IMPORTANCE The prevalence of psychological distress among mothers of children with autism spectrum disorder ( ASD ) suggests a need for interventions that address parental mental health during the critical period after the child 's autism diagnosis when parents are learning to navigate the complex system of autism services . OBJECTIVE To investigate whether a brief cognitive behavioral intervention , problem-solving education ( PSE ) , decreases parenting stress and maternal depressive symptoms during the period immediately following a child 's diagnosis of ASD . DESIGN , SETTING , AND PARTICIPANTS A randomized clinical trial compared 6 sessions of PSE with usual care . Settings included an autism clinic and 6 community-based early intervention programs that primarily serve low-income families . Participants were mothers of 122 young children ( mean age , 34 months ) who recently received a diagnosis of ASD . Among mothers assessed for eligibility , 17.0 % declined participation . We report outcomes after 3 months of follow-up ( immediate postdiagnosis period ) . INTERVENTIONS Problem-solving education is a brief , cognitive intervention delivered in six 30-minute individualized sessions by existing staff ( early intervention programs ) or research staff without formal mental health training ( autism clinic ) . MAIN OUTCOMES AND MEASURES Primary outcomes were parental stress and maternal depressive symptoms . RESULTS Fifty-nine mothers were randomized to receive PSE and 63 to receive usual care . The follow-up rate was 91.0 % . Most intervention mothers ( 78.0 % ) received the full PSE course . At the 3-month follow-up assessment , PSE mothers were significantly less likely than those serving as controls to have clinically significant parental stress ( 3.8 % vs 29.3 % ; adjusted relative risk [ aRR ] , 0.17 ; 95 % CI , 0.04 to 0.65 ) . For depressive symptoms , the risk reduction in clinically significant symptoms did not reach statistical significance ( 5.7 % vs 22.4 % ; aRR , 0.33 ; 95 % CI , 0.10 to 1.08 ) ; however , the reduction in mean depressive symptoms was statistically significant ( Quick Inventory of Depressive Symptomatology score , 4.6 with PSE vs 6.9 with usual care ; adjusted mean difference , -1.67 ; 95 % CI , -3.17 to -0.18 ) . CONCLUSIONS AND RELEVANCE The positive effects of PSE in reducing parenting stress and depressive symptoms during the critical postdiagnosis period , when parents are asked to navigate a complex service delivery system , suggest that it may have a place in clinical practice . Further work will monitor these families for a total of 9 months to determine the trajectory of outcomes . TRIAL REGISTRATION clinicaltrials.gov Identifier : NCT01021384 .
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Intervention_Educational
problem-solving education ( PSE )
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Intervention_Educational
PSE
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Intervention_Control
usual care
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Intervention_Educational
Problem-solving education
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Intervention_Educational
30-minute individualized sessions by existing staff
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Intervention_Control
usual care
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Outcome_Mental
maternal mental health
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Outcome_Mental
parental mental health
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Outcome_Physical
parenting stress
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Outcome_Physical
maternal depressive symptoms
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Outcome_Mental
parental stress
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Outcome_Mental
maternal depressive symptoms
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Outcome_Mental
parental stress
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Outcome_Mental
depressive symptoms
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Outcome_Mental
depressive symptoms
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Outcome_Mental
parenting stress
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Outcome_Mental
depressive symptoms
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Participant_Condition
maternal mental health
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Participant_Condition
child 's diagnosis of autism spectrum disorder
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Participant_Condition
children with autism spectrum disorder ( ASD )
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Participant_Sex
mothers
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Participant_Sample-size
122 young children
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Participant_Sample-size
Fifty-nine