Interventions to Improve Outcomes for Parents of Individuals with Autism Spectrum Disorder: A Meta-Analysis

Background and Purpose: Parents of children with autism spectrum disorders (ASD) tend to experience greater psychological and emotional distress than parents of typically developing children. Interventions for this population have traditionally consisted of skills training and/or knowledge building interventions designed to ultimately improve child outcomes. More recently, researchers have begun to recognize parents as important targets of intervention as well. However, the extent to which parent outcomes are improved by such interventions is unknown. The purpose of this study was to conduct a meta-analytic review of existing interventions for parents of children with ASD in an effort to examine the degree to which they improve parental outcomes.

Methods: A total of 19 peer-reviewed, empirical studies containing 61 effect sizes published between January 1946 and April 2018 were identified from literature searches in relevant databases. Included studies were randomized controlled trials of interventions for parents of children with ASD in which one or more psychological or emotional parental outcome was quantified and measured. Studies were standardized to a common effect size (Cohen’s d) and then subjected to a random-effects multilevel meta-analysis using inverse variance weighting. Meta-regression was conducted to examine potential study-level moderators of intervention efficacy.

Results: Analyses revealed that participation in parent interventions led to small but significant improvements in parent outcomes (d = .32 [95% CI = .12 - .52], p = .002). There was significant heterogeneity in effect sizes, suggesting wide variability in efficacy between studies, Q = 246.09, p < .001. Moderator analysis indicated that the efficacy of parental interventions was not significantly moderated by child age, intervention format (i.e. group/individual), type of instruction, training modality, or treatment duration.

Conclusions and Implications: The impact of parental interventions on psychological and emotional outcomes for parents of individuals with ASD was modest and heterogeneous. While these results suggest promise in assisting parents, more work is needed to develop interventions that have a greater impact on parental outcomes.