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The Effectiveness of a Psychoeducation Intervention delivered via WhatsApp for mothers of children with Autism Spectrum Disorder (ASD) in the Kingdom of Saudi Arabia: A randomized controlled trial
Abstract
Background:
Mothers of children with autism spectrum disorder (ASD) report high levels of stress and lower levels of well-being than parents of typically developing children. Current interventions for ASD typically focus on working with the child rather than delivering strategies to help support parents.
Objective:
To evaluate the effectiveness of a psychoeducation intervention developed to support mothers of children with ASD in Saudi Arabia.
Method:
Sixty-two mothers (23-52 years) of children (26-78 months) were recruited to a multisite randomized controlled trials of the intervention. The intervention consisted of one face-to-face session (60 min) and four virtual sessions (30 min each) delivered using WhatsApp. Parenting stress was the primary outcome, with secondary outcomes focusing on maternal depression, anxiety, and happiness, and child behaviour problems and ASD symptoms. Data were collected at baseline T1, immediately postintervention T2 and 8-week follow-up T3.
Results:
One-way analysis of covariance was used at T2 and T3 with T1 scores entered as a covariate. Improvements were found at T2 for stress (F = 234.34, p = .00, and d = -1.52) and depression (F = 195.70, p = .00, and d = -2.14) but not anxiety, and these results were maintained at T3. Changes in child behaviour problems were limited to improvements in hyperactivity at T2 (F = 133.66, p = .00, and d = -1.54). Although changes in stress and depression were statistically significant, change to clinically normal levels was limited to depression. None of the participants had recovered after the intervention (Parent Stress Index Short Form stress scores), whereas 23 mothers (71.87%) in the intervention group had recovered at T2 and 22 (68.75%) at T3 (Hospital Anxiety and Depression Scale depression scores).
Conclusion:
This intervention with WhatsApp support is beneficial but may need to be augmented with other forms of support for mothers of children with ASD including more condensed sessions on stress and interventions targeting anxiety.
... mHealth interventions signi cantly improved stress compared to the control group in three of the six studies which measured it (50%). 47,57,56 In a single study (17%), the control group, an in-person version of the intervention, reported a signi cantly greater decrease in stress compared to the intervention group. 77 Parent anxiety score was measured in six studies and signi cant intervention-related improvements were observed four times (67%). ...
... 79 Of the seven times across the four studies, there was a signi cant improvement from baseline in child behaviors in ve (71%). 47,53,79 Impact of mHealth interventions on severity of ASD 47 and ADHD 78 symptoms were measured each by one study and a signi cantly positive improvement was observed in both. ...
... 79 Of the seven times across the four studies, there was a signi cant improvement from baseline in child behaviors in ve (71%). 47,53,79 Impact of mHealth interventions on severity of ASD 47 and ADHD 78 symptoms were measured each by one study and a signi cantly positive improvement was observed in both. ...
Background: Parents of children with a health condition experience high levels of distress which can have long-term impact on the child and parent. Dyadic interventions have the potential to decrease this distress, however several barriers to access including time constraints have been reported. Mobile health (mHealth) interventions can address several of these barriers.
Goal: The goal of this systematic review was to review and synthesize the literature examining the effects of parent-oriented mHealth interventions and their content and design.
Methods: We searched PubMed/MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central databases from January 2013 to 2023. Included studies were randomized controlled trials assessing the effect of parent-oriented mHealth interventions on child and parent health. The Cochrane risk-of-bias tool was used to assess for bias in studies. Trial details and design and content features of interventions were extracted. Outcomes were organized using the Van Houtven’s Framework for Informal Caregiver Interventions. Results are presented narratively.
Results: Fifty papers pertaining to 49 unique studies met our inclusion criteria. More than half of the studies scored high-risk for bias. Interventions targeted a wide range of pediatric conditions. Intervention type included texting (n=17) and investigator-developed mobile applications (n=16). Interventions significantly improved parent psychological health and child health outcomes. Key intervention features and design included the use/application of codesign and a theory-driven intervention.
Conclusion: Parent-oriented mHealth interventions identified in this review significantly improved both parent and child health outcomes. Therefore, these interventions have the potential to support parents outside of a clinical setting.
... Interventions were categorized as parent education or parent-mediated interventions (Bearss et al., 2015): parent psychoeducation interventions designed for the benefit of parents, focusing on parental well-being for parents, providing information about the child with ASD's conditions and behaviors, supporting parents to improve their coping styles and reduce psychological distress Francis et al., 2019;Hemdi and Daley, 2017;Iida et al., 2018;Patra et al., 2015), whereas parent training (PT) interventions or parent mediated interventions generally focus on children as primary beneficiaries. These interventions help parents to adapt their own behavior, change and support parent interactions with their children, improve the management of children's difficulties. ...
... This scale is widely used to assess anxiety and depression among parents of children with ASD (Hemdi and Daley, 2017). ...
... The challenges parents face in raising a child with ASD and the deep impact of their attitudes on the prognosis of ASD are a strong argument for the need for parenting training. Our study is one of the few to use an RCT with Arab parents of children with ASD to show the effectiveness of parental outcomes (Alanazi et al., 2022;Alqatarneh et al., 2022;Hemdi and Daley, 2017). ...
Raising a child with ASD can be overwhelming and challenging for parents, and it poses different needs that require support, guidance, and education. Purpose: The aim of this study was to assess the effectiveness of a psychoeducational intervention developed to support parents of children with ASD in Tunisia. A randomized controlled trial was carried out in three Autism socio-educational centers in Tunisia. The study was conducted among parents of children with ASD aged 3 to 8 years from November 2020 to January 2022 (N = 31) compared to a control sample of parents of children attending the same centers but received no specific parent intervention (n = 31). The “Blue Hope” program includes eight training sessions delivered through a combination of face-to-face and online sessions. Results showed that the program significantly improved communication and reduced behavior problems in preschool children with ASD, with a significant positive difference noted at the 6-month follow-up. The program also had a positive impact on parental anxiety and depression, with significant and positive differences observed in anxiety and depression scores and the total score at follow-up compared to baseline. These findings suggest that the “Blue Hope” program could be a cost-effective and valuable solution for parents of children with ASD in Tunisia and could be the first step in developing and improving training programs for parents in low-income countries.
... Without proper support, parents of children with ASD may susceptible to distress. Moreover, previous studies have reported differences in how parents adapt to these stressors and demands (20)(21). Therefore, parents who experience high levels of stress would require strategies to manage their own level of stress and to improv their coping skills. ...
... Therefore, parents who experience high levels of stress would require strategies to manage their own level of stress and to improv their coping skills. One way to support parents of children with ASD is through educational intervention programs (20,21). In such programs, parents receive a comprehensive program within a treatment system with clear and information about effective coping skills (20). ...
... Mothers in the control group received only advice about behavioral problems pertaining to children from their organization. Hemdi and Daley (21) showed that mothers who received educational program via Whatsapp reported a lower level of stress compared with those from the control group. ...
The aim of this systematic review was to evaluate the effectiveness of educational programs on parenting stress and coping mechanism among parents of children with Autism Spectrum Disorder. Our current review retrieved the articles from databases such as CINAHL, Springer, Ovid, PubMed, Google Scholar, and EBSCO host. Only articles published between the years of 2000 and 2018 in these databases were recruited using keywords such as Autism Spectrum Disorder, education program, parenting stress, coping mechanism, and coping strategies. The search generated 17 articles; 8 articles were relevant. This systematic review provides an important opportunity to advance our understanding of the effectiveness of the educational program for reducing parenting stress and improving coping mechanism among parents of children with Autism Spectrum Disorder. Nurses could also have a pivotal role in delivering the educational program for parents of children with ASD.
... The two remaining studies focused on post-traumatic growth (PTG) of mothers with a child with ASD (Zhang et al., 2014) and psychoeducation (Hemdi & Daley, 2017). Both of them used group-based design. ...
... Psychoeducation focuses on providing support and benefit parents of children with ASD (Hemdi & Daley, 2017). The researchers conducted one face-to-face session and four virtual sessions (intervention group) delivered using WhatsApp while the control group received advice from the professionals. ...
... The researchers conducted one face-to-face session and four virtual sessions (intervention group) delivered using WhatsApp while the control group received advice from the professionals. The results showed a statistically significant improvement in parental stress and depression which were maintained at the follow-up but not in anxiety (Hemdi & Daley, 2017). ...
Parents of children with a recently ASD diagnosis face elevated distress and mental health problems like stress, depression, and anxiety. Lately, few interventions which target directly parents’ of preschool children well-being have been implemented in some researches. It was conducted a review of studies that empirically tested the effects of different kind of interventions targeting improvements in parents’ of preschool children with ASD well-being. The objective of this review is to find out the different types of interventions that have been used and the outcomes on parental well-being enhancement. Searching on four databases and following a range of search strategies, a total of 9 studies met inclusion criteria. Findings suggest that in most cases, any type of intervention leads to positive effects on parents’ distress and well-being. However, comparisons and conclusions among the different approaches are difficult to be made, as each of the presented studies follows different methodology. Certainly, more studies have to focus on the parents’ of preschool children with ASD well-being and take into consideration all the limitations of the studies that are reviewed in this paper. Despite this fact, it is very encouraging that more and more researchers and clinicians are concerned about these kinds of interventions in order families with a child with ASD to get supported appropriately.
... The diversity of parents' needs made it difficult for the intervention to suit everyone. Hemdi and Daley (2017) recruited 62 participants from Saudi Arabia in a randomised controlled trial of a psychoeducation intervention consisting of an initial face-to-face session with a therapist and four individual 30-min sessions delivered by WhatsApp. The sessions aimed to reduce maternal stress and child behavioural problems through increasing parent knowledge of ASD, understanding of stress and behaviour management. ...
... The results of this study reinforce calls from other family carer groups for multicomponent online interventions, which integrate psychoeducation, peer-support and psychological support, and are delivered to carers in a flexible and accessible manner (Sin et al., 2018). The preference for a multicomponent intervention highlighted in this study might explain the limited effectiveness of previous single-component, non-tailorable, online interventions at improving outcomes for parents of children on the autism spectrum (Clifford & Minnes, 2013;Hemdi & Daley, 2017). Indeed, a recent systematic review identified that a combination of peer-support, professional stress management and problem-solving training and access to reliable information about ASD are essential to effective mental health interventions for parents (Catalano et al., 2018). ...
... The parents emphasised their desire for psychoeducation, delivered online through interactive information components and direct access to healthcare professionals. Two studies have delivered online psychoeducation to promote problem-focused coping in parents of children on the autism spectrum, yet they were limited in their success, possibly by the small range of topics covered (Bekhet, 2017;Hemdi & Daley, 2017). Parents in this study provided a comprehensive set of psychoeducation topics (i.e. ...
Lay abstract:
Parent caregivers play an essential role in the lives of individuals on the autism spectrum. The demands of caregiving can have negative effects on the mental and physical wellbeing of parents. Different types of formal support have been developed to help parents to cope with caregiving; however, many parents struggle to access services due to limited availability and busy schedules. The Internet could offer parents more accessible and flexible support. We asked 17 parents what content they would like to include in an online resource. Parents told us about their experiences trying to access and use existing formal support and websites. They overwhelmingly supported the development of an online resource informed by their suggestions. Parents emphasised the need for easier access to information through educational components and direct access to healthcare professionals online. Parents also wanted help with finding existing services and reliable, locally relevant information. Parents stressed the need for a safe environment to meet and chat with other parents online. This research forms the first stage in the development process of an online health resource for parents.
... The "country of origin" revealed that the SMP uses for public health promotion in the GCC countries originated remarkably in Saudi Arabia (23/30; 76.7%). [18][19][20][21][22][23][24][25][26]28,29,[31][32][33][34][35][36][38][39][40][42][43][44] Almost all the included studies were published as original research (26/30; 86.7%), 4,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40][41][42][43][44] and only 2 studies were conference proceedings (2/30; 6.7%). 16,18 A qualitative (descriptive in nature) crosssectional study design of the reviewed items using questionnaires or focus groups was predominant (23/30; 76.7%), 4,16,18,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]36,38,39,44 with few interventional studies (3/30; 10%). ...
... The "country of origin" revealed that the SMP uses for public health promotion in the GCC countries originated remarkably in Saudi Arabia (23/30; 76.7%). [18][19][20][21][22][23][24][25][26]28,29,[31][32][33][34][35][36][38][39][40][42][43][44] Almost all the included studies were published as original research (26/30; 86.7%), 4,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40][41][42][43][44] and only 2 studies were conference proceedings (2/30; 6.7%). 16,18 A qualitative (descriptive in nature) crosssectional study design of the reviewed items using questionnaires or focus groups was predominant (23/30; 76.7%), 4,16,18,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]36,38,39,44 with few interventional studies (3/30; 10%). ...
... 16,18 A qualitative (descriptive in nature) crosssectional study design of the reviewed items using questionnaires or focus groups was predominant (23/30; 76.7%), 4,16,18,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]36,38,39,44 with few interventional studies (3/30; 10%). 35,40,42 The specified outcomes of each included study are summarized in Table 1. ...
Social media platforms (SMPs) have emerged as powerful tools for public health promotion. As the 6 countries of the Gulf Cooperation Council (GCC) have the highest internet and social media usage rates in the world, and according to the initiatives for the introduction of a new health system and strategies based on non-traditional methods according to the Saudi Vision 2030, this review aimed to investigate different SMPs use and impact on public health promotion in the GCC countries. Accumulating evidence indicated that diabetes knowledge, women's health, breast-feeding practices, oral health, appropriate antibiotic use, physical activity, road safety awareness, quitting smoking, and breast cancer awareness, were the most common specified topics. Future research should focus on populations that are medically underserved and who have no or limited access to health-care facilities. Also, future research, in particular, the intervention type, is required to cover more countries in the GCC.
... The rate of developmental disabilities affecting children and adolescents has increased steadily across the globe in recent years. In the USA, the prevalence rate of developmental disabilities among children aged between 3-17 years increased from 5.76% in 2014-6.99% in 2016 (Heasley, 2017). Studies have highlighted that parents experience high levels of stress when raising children and adolescents with developmental disabilities. ...
... Two studies (Behbahani, Zargar, Assarian, & Akbari, 2018;Sharif, Zarei, Alavi Shooshtari, & Vossoughi, 2015) were conducted in Iran, two studies (Kleefman, Jansen, Stewart, & Reijneveld, 2014;Van Den Hoofdakker et al., 2007) were conducted in Netherlands. One study (Hands, 2014) was conducted in Kuwait, one study was conducted in Saudi Arabia (Hemdi & Daley, 2017) and one study (Ferrin et al., 2016) was conducted in the UK. Two studies (Chacko, 2006;Hands, 2014) were unpublished theses and the remaining 16 studies (Behbahani et al., 2018;Bor et al., 2002;Feinberg et al., 2014;Ferrin et al., 2016;Hemdi & Daley, 2017;Kleefman et al., 2014;Neece, 2014;Roberts et al., 2006;Roux et al., 2013;Sharif et al., 2015;Sofronoff et al., 2011;Tellegen & Sanders, 2014;Tonge et al., 2006;Van Den Hoofdakker et al., 2007;Whittingham et al., 2016;Wong & Poon, 2010) were peer-reviewed studies. ...
... One study (Hands, 2014) was conducted in Kuwait, one study was conducted in Saudi Arabia (Hemdi & Daley, 2017) and one study (Ferrin et al., 2016) was conducted in the UK. Two studies (Chacko, 2006;Hands, 2014) were unpublished theses and the remaining 16 studies (Behbahani et al., 2018;Bor et al., 2002;Feinberg et al., 2014;Ferrin et al., 2016;Hemdi & Daley, 2017;Kleefman et al., 2014;Neece, 2014;Roberts et al., 2006;Roux et al., 2013;Sharif et al., 2015;Sofronoff et al., 2011;Tellegen & Sanders, 2014;Tonge et al., 2006;Van Den Hoofdakker et al., 2007;Whittingham et al., 2016;Wong & Poon, 2010) were peer-reviewed studies. ...
Aims:
To evaluate the effectiveness of psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities.
Design:
A systematic review and a meta-analysis.
Data sources:
Seven electronic databases (CINAHL, CENTRAL, EMBASE, ProQuest Dissertation and Theses, PsycINFO, PubMed and Scopus) were searched from each database's point of inception to December 2018.
Review methods:
Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Data were analysed using Review Manager 5.3. The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system.
Results:
A total of 18 studies were included in this review. Eleven studies were involved in a meta-analysis and the remaining seven studies were summarized narratively. The meta-analysis found that psychological interventions significantly reduced parental stress at postintervention but not at 3-6 months' postintervention. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety.
Conclusion:
Psychological interventions appeared to reduce parental stress temporarily. Healthcare professionals can offer varied psychological interventions for parents to choose from. Policymakers can ease accessibility and affordability for parents to attend interventions.
Impact:
Psychological interventions were found to have short-term effects in reducing parental stress. Inconclusive evidence was found for the effectiveness of psychological interventions in reducing parental depression and anxiety. Healthcare professionals should ensure that knowledge is transmitted to parents when delivering their interventions. Policymakers worldwide should ensure that parents of children and adolescents with developmental disabilities can attend interventions by making them accessible and affordable.
... However, with the outbreak of the COVID-19 pandemic, the mental state of parents with children hospitalized is further affected (23). The study of Hamdi et al. showed that mothers' depression improved after the intervention, but their anxiety did not change; therefore, in future studies, it seems necessary to focus on different aspects of mothers' psychological functioning with participation of fathers (24). But one weakness of our study was lack of examination of fathers' stress as a family member. ...
... However, unlike the present study, no significant effect on stress was observed(26). Hamdi et al. also reported their educational intervention through WhatsApp, as in the present study, reporting a reduction in maternal stress(24). Research conducted by Jafarpour and Hemdi showed that educational and supportive programs reduced maternal stress, which was in line with this study. ...
Objective: Stress and anxiety in the mother as one of the most important members of the child's health can delay recovery and prolong hospitalization of the child. However, families feel very anxious or stressed because of the limitations imposed by COVID-19; therefore, it is important for physicians and nurses who work with children and families to recognize and reduce family stress. This study aimed to investigate the effect of implementing an educational-supportive program on improving family-centered care with bedside telehealth.
Method: In this clinical trial, 40 parents with hospitalized children were selected and randomly assigned to control and intervention groups. The intervention group received a supportive training program, including teaching parental roles and supportive methods for the child and mother during the illness, while nurse counseling and support role was performed virtually as part of the intervention. After the virtual and visual implementation of the training, the father established online video communication with the child and the mother as the primary caregiver. Data collection tools were a demographic questionnaire and Stress Response Inventory (SRI) completed by the mother before and after seven days of intervention. The control group received routine care.
Results: After the intervention, mothers in the intervention group showed significantly lower levels of stress than before the intervention (P < 0.05). Stress level of mothers in the control group did not demonstrate significant difference before and after the intervention (P > 0.05). Also, a comparison of mothers' stress scores post-intervention showed significant difference between the two groups (P < 0.05).
Conclusion: Planning and maintaining family integrity during the COVID-19 pandemic along with educating and supporting fathers through the supportive role of spouses can reduce stress of mothers with hospitalized children.
... After systematically removing one study at a time, it was observed that four studies affected the meta-estimate of the effect size of parenting eHealth interventions by more than 5% (David et al., 2017;Fidika et al., 2015;Hemdi & Daley, 2017;Sourander et al., 2016). One study (David et al., 2017) affected the meta-estimate such that it made the estimate less conservative, although a significant association was still noted without the study included (p < 0.001). ...
... Three studies affected the meta-estimate such that they made the estimate more conservative; a significant association was still noted without the studies included (p < 0.001). Upon evaluation of study quality, two of the studies (David et al., 2017;Sourander et al., 2016) were deemed to be moderate quality (rated as 6 and 7 out of 14) and two studies were evaluated to be of high quality with one study being rated as 12 of 14 (Hemdi & Daley, 2017), and the other study being rated as 9 of 11 (Fidika et al., 2015). As such, all of the identified studies were included in the analyses. ...
Parent stress and mental health problems negatively impact early child development. This study aimed to systematically review and meta-analyze the effect of eHealth interventions on parent stress and mental health outcomes, and identify family- and program-level factors that may moderate treatment effects. A search of PsycINFO, Medline, CINAHL, Cochrane and Embase databases was conducted from their inception dates to July 2020. English-language controlled and open trials were included if they reported: (a) administration of an eHealth intervention, and (b) stress or mental health outcomes such as self-report or clinical diagnosis of anxiety and depression, among (c) parents of children who were aged 1–5 years old. Non-human studies, case reports, reviews, editorials, letters, dissertations, and books were excluded. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Random-effects meta-analyses of standardized mean differences (SMD) were conducted and meta-regressions tested potential moderators. 38 studies were included (N = 4360 parents), from 13 countries (47.4% USA). Meta-analyses indicated eHealth interventions were associated with better self-reported mental health among parents (overall SMD = .368, 95% CI 0.228, 0.509), regardless of study design (k = 30 controlled, k = 8 pre-post) and across most outcomes (k = 17 anxiety, k = 19 depression, k = 12 parenting stress), with small to medium effect sizes. No significant family- or program-level moderators emerged. Despite different types and targets, eHealth interventions offer a promising and accessible option to promote mental health among parents of young children. Further research is needed on moderators and the long-term outcomes of eHealth interventions. Prospero Registration: CRD42020190719.
... Social media could be one form of ongoing support to connect healthcare providers with families. In Saudi Arabia, Hemdi and Daley [21] utilized an instant messaging app to educate and support mothers raising autistic children, which significantly reduced stress and clinically reduced depression over time. While this form of intervention could reach more families (e.g., rural and remote), the authors suggested it be augmented with other services such as respite [21]. ...
... In Saudi Arabia, Hemdi and Daley [21] utilized an instant messaging app to educate and support mothers raising autistic children, which significantly reduced stress and clinically reduced depression over time. While this form of intervention could reach more families (e.g., rural and remote), the authors suggested it be augmented with other services such as respite [21]. Mothers in the present study and in past research have expressed great need for respite services when raising autistic children [4]. ...
... 16 Its clinical use in different health care scenarios has been suggested by several studies. [17][18][19] These encouraging data prompted us to investigate the potential role of the WhatsApp Messenger in CRC screening. We hypothesized that text reminders sent via WhatsApp Messenger improve longitudinal adherence to a stool-based CRC screening program. ...
... 5 The usefulness of WhatsApp Messenger, a free-to-use mobile messenger, has been demonstrated in multiple clinical settings, including reductions in emergency department length of stay, 17 improvements in smoking abstinence, 18 and reductions in stress levels in parents with autistic children. 19 These encouraging results have prompted us to evaluate the potential role of WhatsApp in a community-based, opportunistic CRC screening program. ...
Background
The fecal immunochemical test (FIT) is a cost‐effective colorectal cancer (CRC) screening tool. However, longitudinal adherence, a factor that is critical to the success to any FIT‐based screening program, often is poor. The authors hypothesized that reminders sent via mobile messengers, such as WhatsApp, improve such adherence.
Methods
In the current single‐blind, randomized study, subjects from an opportunistic FIT screening program who had a negative FIT result the year prior were randomly allocated (1:1) to receive either a 1‐off reminder via the WhatsApp messenger (WR) 1 month prior to the due appointments or no reminder (NR). All subjects were blinded to study participation and group allocation. At 24 months after randomization, a crossover of intervention was performed among those individuals who remained in the FIT program. The primary outcome was FIT adherence, defined as the pick‐up and on‐time return of the FIT. The secondary outcome was FIT adherence after the crossover.
Results
A total of 500 subjects were randomized to receive WR (250 subjects) or NR (250 subjects). Three individuals were excluded from analysis (1 died and 2 underwent colonoscopy). Both the FIT pick‐up rate (80.3% vs 59.3%; P < .001) and return rate (79.9% vs 57.3%; P < .001) were significantly higher in the WR group compared with the NR group. After crossover of intervention (452 subjects), the WR group again was found to have a higher FIT pick‐up rate (79.1% vs 52.9%; P < .001) and return rate (78.2% vs 52.4%; P < .001).
Conclusions
Text reminders sent via mobile messenger appear to improve the longitudinal adherence to FIT‐based opportunistic CRC screening programs. The routine use of this technology in CRC screening should be considered.
... [27] A recent study used WhatsApp. [28] They used one face-to-face session (60 min) and four virtual sessions (30 min each), with parental psychological issues being the primary outcome and child behavior problems and ASD symptoms being the secondary ones. Parental training was compared to parental PE in a randomized control trial for parental stress, strain, and competence. ...
... Investigators in Saudi Arabia reported a reduction in stress and depression in mothers with children with autism, with only one face to face session, followed by four WhatsApp sessions. [28] Positive change persisted for 8 weeks. However, a second group found that training parents in behavioral strategies helped to reduce their stress and improved their sense of competence, while PE alone was less effective. ...
Objectives: Children with autism with/without intellectual disability (ID) and ID alone require regular interventions. Psychoeducation (PE) can empower parents with intervention strategies. The aim of this study was to develop the test efficacy of a simple, short manualized PE module for parents of children with autism with/without comorbid ID and for ID alone. We focused on both autism and ID (A‑ID) because we felt that both the groups could benefit from this module. Methods: A special module for PE was developed after literature review, inputs from a study group,and discussion with experts. Parents attended eight fortnightly intervention sessions. Children were assessed on the Developmental Screening Test, Indian Scale for Assessment of Autism (ISAA), and the Behavioral Assessment Scale for Indian Children with Mental Retardation (BASIC‑MR) before starting and 1 month after completing PE. Results: Consenting parent of parents/of 16 children with A‑ID and 14 with ID completed sessions with pre‑ and postassessment. There was a significant improvement in the majority of domains of ISAA and BASIC‑MR Part B in children with both conditions. Conclusions: PE has a wide scope for use across various developmental disorders. The module developed is promising for a wide variety of field workers.
Keywords: Autism, developmental disorders, intellectual disability, Indian Scale for Assessment of Autism, module, psychoeducation
... [27] A recent study used WhatsApp. [28] They used one face-to-face session (60 min) and four virtual sessions (30 min each), with parental psychological issues being the primary outcome and child behavior problems and ASD symptoms being the secondary ones. Parental training was compared to parental PE in a randomized control trial for parental stress, strain, and competence. ...
... Investigators in Saudi Arabia reported a reduction in stress and depression in mothers with children with autism, with only one face to face session, followed by four WhatsApp sessions. [28] Positive change persisted for 8 weeks. However, a second group found that training parents in behavioral strategies helped to reduce their stress and improved their sense of competence, while PE alone was less effective. ...
... For example, caregivers who engage with social support interventions in their home, accessing them online, report notable reductions in feelings of depression (Clifford & Minnes, 2013;Cole et al., 2017). Educational interventions that provide caregivers more information about autism and making recommendations about how to cope with caregiving struggles, when packaged as a cheap and easily accessible mobile app, also effectively alleviate caregivers' stress (Hemdi & Daley, 2017). ...
Psychotherapeutic interventions such as cognitive training and psychoeducation tend to be effective for alleviating stress in caregivers of children with autism. However, these interventions are often time consuming and take place outside the home, posing challenges for accessibility. Technology, especially virtual reality (VR) technology, can be used to support a range of digital interventions at home. VR headsets, when used to simulate relaxing experiences, have already been linked with stress relieving effects for some caregiving groups. This study builds on this, exploring whether VR simulated relaxing environments engender positive psychological changes for caregivers of children with autism. A total of 18 caregivers were exposed to VR simulated natural environments (e.g., beach, forest) for 15 min in a single session. State mood, captured with POMS, was measured at baseline and immediately post intervention. Perceived stress (PSS) was captured at baseline and, to explore intervention effectiveness, at three- and seven-days post intervention. POMS scores for tension, anger, depression, fatigue and confusion were lower, and scores for vigour higher, immediately post intervention. PSS scores at three-and seven-days post intervention, while comparable with one another, were lower compared with baseline. Interacting with simulated natural environments in VR seems effective for improving caregivers’ state mood and reducing their perceived stress for up to seven days. Future research should aim to consolidate and expand on these findings with larger samples and longer follow up periods.
... Numerous innovative programs were trialled, suggesting that there is not a one size fits all solution to better support mothers who have substantial care responsibilities. Although excluded from this review, numerous other programs have been developed for mothers in other countries such as Malawi (Masulani-Mwale et al. 2019) and Saudi Arabia (Hemdi and Daley 2017). While rigorous evaluation of such programs remains forthcoming, the international attention on mother's wellbeing demonstrates that it is a priority where children with disabilities receive services. ...
Rationale: Substantial research indicates that mothers of children with disabilities require stand alone, mother focused interventions to protect maternal health of the long term.
Objective: To conduct a thorough systematic review to investigate the effectiveness of interventions that aim to improve the mental health of mothers of children with disabilities.
Method: A registered systematic review includes search of seven databases. Interventions incorporated primarily cognitive-behavioural, health and psychoeducation, mindfulness or support-group approaches. The Template-for-Intervention-Description-and-Replication (TIDIER) guided descriptions. Meta-analyses using a random effect model of randomized controlled trials assessed intervention effects on parenting stress and mental health.
Results: Interventions were conducted in 16 countries and programs varied. Over 1500 papers were identified although only 31 met criteria to be appraised and 17 were included in the meta-analysis. Cognitive-behavioural approaches reduced parenting stress [2 studies, n = 64, pooled Standardized-Mean-Difference (SMD) = 0.86, 95% CI (0.43, 1.29)] and improved mental health [3 studies, n = 186, pooled SMD = 1.14, 95% CI (0.12, 2.17)], psychoeducation approaches improved mental health [2 studies, n = 165, SMD = 0.60, 95% CI (0.17, 1.03)]. The details of interventions were described using TIDIER.
Conclusion: Research evidence suggests that protecting maternal mental health and wellbeing is a world-wide goal and further research on what is effective and development of clinical guidelines are warranted.
(Bourke-Taylor, H.M., Lee, D.C.A., Tirlea, L., Joyce, K., Haines, T. (2021) Support for the mental health of mothers of children with a disability: Systematic review, meta-analysis and description of interventions. Journal of Autism and Developmental Disorders 51(10), 3690-3706.)
... Regarding specific MIM services, two tools were Four types of participants were involved in the reviewed studies, including: (a) teachers (n ¼ 4) (e.g., Allela et al. 2020;Moodley 2019;Xue et al. 2021); (b) healthcare professionals (n ¼ 5), including doctors, clinicians, and nurses (e.g., Oyewole et al. 2020;Pimmer et al. 2019;Torrejon et al. 2020); (c) professionals in other areas (n ¼ 2), such as professionals in environment and nature studies (Gil 2019) and firefighters (Ng and Cheung 2020); and (d) people seeking help (n ¼ 11), such as patients, their relatives, or others who are in need of medical guidance or psychological support. Examples of participants in this group include residents being quarantined during COVID-19 (Hu et al. 2020), adults with hypertension , and parents of children with autism spectrum disorder (Hemdi and Daley 2017). ...
With the changes in the way we communicate and collaborate, lifelong learners are facing new requirements, opportunities, and challenges. One technology holds promise to facilitate lifelong learning via a unique quasi-synchronous communicative mode: mobile instant messaging (MIM). In this study, we operationalized lifelong learning in the context of professional adult education as learning that goes beyond instruction-driven pedagogy in formal learning contexts. Inspired by the theory of heutagogy, we conducted an extensive review of the research and reported on the contexts, approaches, benefits, and challenges of using MIM in professional learning. The results show that related studies had just started to emerge in recent years (since 2017) and focused mainly on two MIM services – WeChat and WhatsApp. MIM were mainly used by professionals such as teachers and doctors, as well as people in need of professional help. People used MIM tools to establish online communities of practices, disseminate knowledge, and seek for help. We identified an array of beneficial features of MIM to support lifelong learning, including ease of use, multimodality, immediacy, continuance, flexibility, and comfort. The challenges of using MIM to support lifelong learning include the size limit of WhatsApp groups, the chronological features, the intrusiveness of irrelevant messages, and the concerns over user privacy. This work makes a theoretical contribution by researching heutagogy in the unique research context of MIM use in lifelong learning and provides practical evidence and suggestions for practitioners to better utilize technologies to engage learners in lifelong learning activities.
... Research conducted by (Hemdi, A., & Daley, 2017) involving 62 mothers in the Kingdom of Saudi Arabia : session 1 to inform parents about the etiology of ASD, session 2 to target stress in mothers and how they can approach different stressful situations, session 3 to child behavior problems to help mothers cope with the initial stressors of having a child with ASD, and session 5 to inform mothers about available resources. The intervention material was developed in a booklet format which was divided into five parts. ...
Introduction: Autism is a disruption verbal, nonverbal, and social interaction growth in children. Children with autism spectrum disorder have a different parenting program with normal children. A mother who has autism spectrum disorder children need for more space up her time to treat their children right, and sometimes they will have their stress moments because of what they think about their autism spectrum disorder children. This study aims to explain the interventions to enhace the coping of parents of children with autism.Method: The literature was searched using electronic database: Scopus, CINAHL, Science Direct, Sage, Google Schoolar with inclusion criteria include: parents of children with Autism Spectrum Disorder, articles published in 2011-2021 using experimental studies in English and Indonesian. Ten articles obtained for review.Result: Ten articels that fulfill a searching requirement and chosen to be analyzed. From ten articels there are divided into two interventions on it, Cognitive Based Intervention wich are Parent Education Program, Coping Effectiveness Training, Mindfulness-Based Interventions, Problem-Solving Skills Training, and Psychological Based Intervention wich are Virtual Resilience Intervention.Conclusion: This research shows that some interventions or programs that have been examined effectively can increase coping at parents who has autism spectrum disorder children. The intervention that is considered the most effective and often used is the parent education program.
... This result was in disagreement with Alqahtani (2015) who reported in his study about "understanding autism in Saudi Arabia: a qualitative analysis of the community and cultural context", that parents of children with ASD in KSA often choose informal intervention and treatments such as diet intervention containing gluten-casein-free as a treatment option for their autistic children. However, this study result goes in the same line with Hemdi and Daley(2017) who reported in their study about "The needs of mothers of children with ASD in the Kingdom of Saudi Arabia (KSA): a qualitative study", that parents prefer to seek behavioral and educational interventions as a treatment option for their autistic children. ...
... There are several real-time communication tools as mobile phone application. The recent studies showed that the one of these tools 'Whatsapp' was previously used as a tool for cancer screening [5], autism spectrum disease training [6], smoking relapse prevention programs [7]. ...
HOME-BASED PALLIATIVE CARE VIA SMARTPHONE APPLICATIONS DURING THE PANDEMIC
... [37] Indeed, constructive psychoeducational interventions were effective in ameliorating stress-related and depressive symptoms among Saudi mothers of children with ASD. [38] The current study has many strengths. We used a validated structured tool, namely the PHQ-9, to identify the extent of depressive symptomatology. ...
Background:
Autistic spectrum disorder (ASD) is a common problem in the Kingdom of Saudi Arabia. However, little research explored the extent of anxiety and depressive disorders in parents of children with ASD.
Method:
Descriptive questionnaire-based cross-sectional survey of a sample of parents of children with ASD who attended Prince Mohammed Bin Salman Autistic Centre, Ministry of defense, Taif city.
Results:
The study included (n = 50) parents. The prevalence of mild depression was 30%, whereas the prevalence of moderately severe depression was 68%. Increased ASD severity level was associated with a significant impact on the PHQ-9 total score (level II was 1.293 times level I to have an increased PHQ-9 score, and level III was 1.530 times level I to have an increased PHQ-9 score). Economic status did not significantly alter depressive symptoms.
Discussion and conclusion:
ASD diagnosis in Saudi children is associated with high parental depressive prevalence. However, this result could be bidirectional. Stigma, future-related worry, and stress could mediate parental depressive symptoms. Our findings in Saudi parents of children with ASD corroborate the established association between parental depressive symptoms and ASD severity. Our results corroborated previous findings that neither parental gender nor child gender exert any substantial effect on predictability of depressive symptoms among parents of children with ASD. Comprehensive therapeutic packages for children with ASD should include treatment of emotional problems arising out of carer burden among their parents. Screening for parental emotional problems should be routine in autism treatment facilities.
... Numerous innovative programs were trialled, suggesting that there is not a one size fits all solution to better support mothers who have substantial care responsibilities. Although excluded from this review, numerous other programs have been developed for mothers in other countries such as Malawi (Masulani-Mwale et al. 2019) and Saudi Arabia (Hemdi and Daley 2017). While rigorous evaluation of such programs remains forthcoming, the international attention on mother's wellbeing demonstrates that it is a priority where children with disabilities receive services. ...
To investigate the effectiveness of interventions that aim to improve the mental health of mothers of children with disabilities. Seven databases were searched. Interventions incorporated primarily cognitive-behavioural, psychoeducation, mindfulness or support-group approaches. The Template-for-Intervention-Description-and-Replication guided descriptions. Meta-analyses using a random effect model of randomized controlled trials assessed intervention effects on parenting stress and mental health. Of the 1591 retrieved papers, 31 met criteria to be appraised and 17 were included in the meta-analysis. Cognitive-behavioural approaches reduced parenting stress [2 studies, n = 64, pooled Standardized-Mean-Difference (SMD) = 0.86, 95% CI (0.43, 1.29)] and improved mental health [3 studies, n = 186, pooled SMD = 1.14, 95% CI (0.12, 2.17)], psychoeducation approaches improved mental health [2 studies, n = 165, SMD = 0.60, 95% CI (0.17, 1.03)]. Cognitive-behavioural and psychoeducation interventions are effective. Further research and clinical guidelines are warranted.
... Por ejemplo, en la ciencia médica se han estudiado las potencialidades comunicativas de dicha aplicación como herramienta que facilite la labor de los médicos, desde el entorno educativo hasta la toma de decisiones clínicas o de diagnóstico (Ganasegeran, Renganathan, Rashid, & Al-Dubai, 2017;Loo, Koh, Pong, & Nor, 2016;Nair, Mudunuri, Ganapathy, & Kulkami, 2016;Wajekar, 2017;Wani, Rabah, AlFadil, Dewanjee, & Najmi, 2013). En psicología, la atención ha sido enfocada en los efectos de este sistema de mensajería instantánea en la salud mental de los usuarios (Faye, Gawande, Tadke, Kirpekar, & Bhave, 2016;Sánchez Díaz de Mera & Lázaro Cayuso, 2017;Tresancoras, García-Oliva, & Piqueras, 2017;Wegmann & Brand, 2016), y se ha explorado como herramienta terapéutica (Cheung, Chan, Wang, Li, & Lam, 2017;Hemdi & Daley, 2017). ...
El objetivo del artículo es caracterizar WhatsApp a partir de las creencias y actitudes lingüísticas de los participantes en tres grupos conversacionales. Se trata de un estudio cualitativo, exploratorio y no experimental que se realizó con la aplicación de entrevistas a los administradores de cada grupo. A partir de los resultados, se reflexiona sobre la aceptación de esta manifestación de la escritura en la virtualidad, por ejemplo, en WhatsApp, puesto que es un testimonio más de las capacidades y estrategias comunicativas del ser humano.
... There were also some studies focused on parent support interventions (including information and emotion support) and wellness promotion (purpose) for families of children with challenging behavior. For these support/wellness interventions, social media, and groupbased e-support strategies (e.g., Facebook, WhatsApp), with or without in-person sessions, were generally applied (43,46,52). ...
Background: The burden of mental, neurological, and substance (MNS) disorders is greater in low- and middle-income countries (LMICs). The rapid growth of digital health (i.e., eHealth) approaches offer new solutions for transforming pediatric mental health services and have the potential to address multiple resource and system barriers. However, little work has been done in applying eHealth to promote young children’s mental health in LMICs. It is also not clear how eHealth has been and might be applied to translating existing evidence-based practices/strategies (EBPs) to enable broader access to child mental health interventions and services.
Methods: A scoping review was conducted to summarize current eHealth applications and evidence in child mental health. The review focuses on 1) providing an overview of existing eHealth applications, research methods, and effectiveness evidence in child mental health promotion (focused on children of 0–12 years of age) across diverse service contexts; and 2) drawing lessons learned from the existing research about eHealth design strategies and usability data in order to inform future eHealth design in LMICs.
Results: Thirty-two (32) articles fitting our inclusion criteria were reviewed. The child mental health eHealth studies were grouped into three areas: i) eHealth interventions targeting families that promote child and family wellbeing; ii) eHealth for improving school mental health services (e.g., promote school staff’s knowledge and management skills); and iii) eHealth for improving behavioral health care in the pediatric care system (e.g., promote use of integrated patient-portal and electronic decision support systems). Most eHealth studies have reported positive impacts. Although most pediatric eHealth studies were conducted in high-income countries, many eHealth design strategies can be adapted and modified to fit LMIC contexts. Most user-engagement strategies identified from high-income countries are also relevant for populations in LMICs.
Conclusions: This review synthesizes patterns of eHealth use across a spectrum of individual/family and system level of eHealth interventions that can be applied to promote child mental health and strengthen mental health service systems. This review also summarizes critical lessons to guide future eHealth design and delivery models in LMICs. However, more research in testing combinations of eHealth strategies in LMICs is needed.
... In fact, the number of articles I found using the same keywords for the same period was much higher (1,538 titles), so perhaps the keywords might not have been used properly in the researching process. In fact, quickly skimming PubMed alone turned up several other important RCTs conducted in Saudi Arabia [2][3][4][5]. None of these articles were among the 61 articles listed in the review. This jeopardizes the integrity of article selection in this systematic review, and because many important articles were not included, the authors are unable to make their conclusion. ...
... 23 Clinical practice guidelines also provide suggestions regarding different interventions to support families of patients with CHD. 26 Indeed, interventions designed for parents could have a positive impact on child outcomes. 27,28 For instance, the congenital heart disease intervention programme (CHIP)-school aimed to promote adjustment in children with CHD and their families by bolstering parenting skills, and its results demonstrated B: unstandardized regression coefficients; CHD: congenital heart disease; SE: standard error; -: not applicable; a path: association between cyanotic CHD and parenting stress after controlling for covariates; b path: association between parenting stress and internalising problems after controlling for covariates; c′ path: association between cyanotic CHD and internalising problems after controlling for parenting stress and covariates. ...
Background
Children and adolescents with cyanotic congenital heart disease have been found to be at an increased risk of internalising problems. The underlying mechanisms, however, remain uncertain.
Aims
To examine the association between cyanotic congenital heart disease and internalising problems and assess whether parenting stress mediates this association.
Method
The study sample was 699 children and adolescents (aged 2–17 years) with congenital heart disease (253 with cyanotic congenital heart disease and 446 with acyanotic congenital heart disease) in Taiwan. The Child Behavior Checklist and the Parenting Stress Index were used to assess internalising problems and parenting stress, respectively. A series of multiple regression models was conducted using the SPSS PROCESS procedure to test the association between types of congenital heart disease and internalising problems and the mediating role of parenting stress. A bootstrapping approach was applied to determine the significance of mediation.
Results
Compared with acyanotic congenital heart disease, cyanotic congenital heart disease was associated with increased levels of internalising problems (B=2.52, P<0.01), and this association was mediated by parenting stress (B=0.97, 95% bias-corrected bootstrap confidence interval 0.24, 1.75). In particular, parents of children with cyanotic congenital heart disease reported significantly more parenting stress compared with parents of children with acyanotic congenital heart disease (B=4.63, P<0.01), which contributed to elevated levels of internalising problems in the offspring (B=0.21, P<0.001).
Conclusion
Cyanotic congenital heart disease conferred risks for internalising problems in children and adolescents, and this association was mediated by parenting stress. Interventions to decrease internalising problems in children and adolescents with cyanotic congenital heart disease may be more effective by targeting parenting stress.
... The world revolves around technology, which enhances social interaction; facilitates knowledge sharing among health professionals, individuals with ASD, and the whole community; and will lead to positive change in the health sector (eg, through treatment plans) [28]. For example, the use of mobile internet technology such as WhatsApp has shown promising results in reducing stress through interventions in Saudi parents of children with ASD [29]. ...
Autism spectrum disorders (ASD) are the most-prevalent neurodevelopmental disorders. However, each child diagnosed with ASD presents with a unique range of behavioral and communication problems and issues with social skills. Many studies have highlighted the importance of early interventions for children with ASD to improve their skills and provide their families with the necessary support. However, in the Kingdom of Saudi Arabia (KSA), the earliest that a child with ASD in the major cities receives an intervention is at the age of 4 years, owing to limited services and a lack of awareness of the importance and benefits of early interventions. Families who live in rural areas of KSA arguably have a greater need for these services, as they have to travel to cities such as Riyadh for help. The use of telehealth services may be effective for ASD intervention among children living in rural areas, since such services use technology to provide consultations, interventions, diagnosis, training, and education. Research indicates that telehealth services are as valuable as traditional face-to-face treatment, allow families to obtain support from their homes, and help them improve their quality of life. This review will discuss the application of telehealth services to support families in rural areas of KSA who are dealing with issues of ASD, considering the cultural and religious contexts. In addition, it will examine ways in which technology can be employed to suit KSA's culture and needs.
... Our findings seem to support this statement, indicating that guardians with concerns regarding their children's gaming will be more attentive to relevant information. Comparing our findings with previous studies of psychoeducative interventions, we find that other interventions seem to offer other supportive factors as well as written materials (e.g., personal contact with health professionals, group activities, etc.) (Bai, Wang, Yang, & Niu, 2015;Hemdi & Daley, 2017). The lack of supplementary supportive elements may explain why this study had such small impact. ...
Background and aims
Excessive use of video games among children and adolescents is a growing concern. The aim of this study was to investigate the effectiveness of a brief parental guide with advices and strategies for regulating video gaming in children.
Methods
A random sample of guardians of children between the age of 8–12 years old (N = 5,864) was drawn from the Norwegian Population Registry and equally randomized into an intervention and a control condition. A parental guide based on clinical and research literature was distributed by postal mail to those in the intervention condition. A 4-month follow-up survey comprising questions about problematic video gaming, gaming behavior, sleep activity, and parental video game regulation behavior was administered.
Results
Independent t-tests revealed no significant differences between the two conditions (N = 1,657, response rate 30.1%) on any outcome measure. An ANOVA with planned comparisons showed that respondents who reported that they had read and followed the parental guide reported more video game problems and used more parental mediation strategies than those who did not read and follow the guide.
Conclusions
We found no evidence for the effectiveness of the psychoeducational parental guide on preventing problematic video gaming in children. However, the guide was read and positively assessed by a significant proportion of guardians. Differences between those who studied the guide and those who did not may indicate that parental guides are better aimed at providing important information to those who already have problems rather than as a mean of primary prevention.
Ce travail se veut une exploration de l’influence de différents environnements, par le modèle de Bronfenbrenner, et de leurs interactions sur l’expérience de l’adulte autiste sans trouble du développement intellectuel associé et par extension de sa conception clinique, à travers : a) l’étude des différents modèles de l’autisme et de leur influence sur les conceptionscliniques et in fine sur les individus ; b) l’exemple de l’expérience du camouflage autistique et de la stigmatisation pour incarner l’influence de différents environnements sur l’individu ; c) l’étude de l’expérience et des besoins identifiés à la
suite de la réception d’un diagnostic à l’âge adulte et enfin d) la présentation du développement et du protocole d’évaluation d’une intervention de psychoéducation, le programme CoMPPAA. Ces éléments permettent notamment d’appuyer l’importance du développement de modèles de recherche participative pour améliorer la validité écologique de la recherche sur l’autisme.
--
This work is an exploration of environmental influence (using Bronfenbrenner’s framework) and their interactions on the experience of autistic adults without intellectual disability and by extension of the clinical conceptualisation of autism,
via : a) the study of different models of autism and their influence on clinical frameworks as well as on autistic individuals ; b) using the examples of autistic masking and stigmatisation to embody the dynamic influences of the environnement
on the individual ; c) considering the experience of receiving an autism diagnosis as an adult as well as needs identified following the diagnosis and d) the development and evaluation protocol of a psychoeducational intervention (the CoMPPAA program). This allows for the consideration of participatory research models as crucial to enhance the
ecological validty of autism research.
Background:
Youth mental health problems are a major public health concern and are strongly associated with adverse childhood experiences (ACEs). Technology-assisted parenting programs can intervene with ACEs that are within a parent’s capacity to modify. However, engagement with such programs is suboptimal.
Objective:
This review aims to describe and appraise the efficacy of strategies used to engage parents in technology-assisted parenting programs targeting ACEs on the behavioral and subjective outcomes of engagement.
Methods:
Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines, we conducted a systematic review of peer-reviewed papers that described the use of at least 1 engagement strategy in a technology-assisted parenting program targeting ACEs that are within a parent’s capacity to modify. A total of 8 interdisciplinary bibliographic databases (CENTRAL, CINAHL, Embase, OVID MEDLINE, OVID PsycINFO, Scopus, ACM, and IEEE Xplore) and gray literature were searched. The use of engagement strategies and measures was narratively synthesized. Associations between specific engagement strategies and engagement outcomes were quantitatively synthesized using the Stouffer method of combining P values.
Results:
We identified 13,973 articles for screening. Of these, 156 (1.12%) articles were eligible for inclusion, and 29 (18.2%) of the 156 were associated with another article; thus, 127 studies were analyzed. Preliminary evidence for a reliable association between 5 engagement strategies (involving parents in a program’s design, delivering a program on the web compared to face-to-face, use of personalization or tailoring features, user control features, and provision of practical support) and greater engagement was found. Three engagement strategies (professional support features, use of videos, and behavior change techniques) were not found to have a reliable association with engagement outcomes.
Conclusions:
This review provides a comprehensive assessment and description of the use of engagement strategies and engagement measures in technology-assisted parenting programs targeting parenting-related ACEs and extends the current evidence with preliminary quantitative findings. Heterogeneous definition and measurement of engagement and insufficient engagement outcome data were caveats to this synthesis. Future research could use integrated definitions and measures of engagement to support robust systematic evaluations of engagement in this context.
This study investigated the relationship between traumatic life stress, trust, and prosocial behavior as a positive mental health outcome in Syrian refugee children in Canada. Trust is a resilience factor shown to promote adjustment after resettlement. The specific goals of the study were to test the influence of refugee children’s traumatic life stress on their prosocial behavior and the mediating role of trust in this link. Five- to 12-year-old Syrian refugee children ( N = 124) and their caregivers ( N = 51) who recently resettled in Canada participated in this study. Children retrospectively reported their experiences of traumatic life stressors, and caregivers reported their children’s current level of trust and prosocial behavior using questionnaires. Traumatic life stress (e.g., witnessing violence and conflict, separation from family, death of family members) was negatively related to refugee children’s trust in others, while trust was related to more prosocial behaviors, confirming its mediating role. These results suggest that experiencing more traumatic life stressors is associated with less prosocial behaviors as a positive mental health outcome through lower levels of trust. The current findings suggest that fostering trust may be a promising avenue for intervention to promote prosocial behavior and resilience in refugee children who are resettling in a new society.
Aim
To systematically review the effectiveness of caregiver and parent skills training programs, including caregiver‐mediated interventions, for caregivers of individuals with neurodevelopmental disorders.
Method
We conducted a systematic review with a random‐effects meta‐analysis. We searched 11 electronic databases through July 2021 and used a snowball methodology to locate relevant articles of randomized controlled trials. Effect size estimates were pooled using Hedges' g from data extracted from study reports and through author requests using random‐effects meta‐analyses for three child outcome categories (child development, adaptive behavior, and problem behavior) and three caregiver outcome categories (parenting skills and knowledge, psychological well‐being, and interpersonal family relations).
Results
We located 44 910 records, from which 75 randomized controlled trials involving 4746 individuals with neurodevelopmental disorders and their caregivers were included. Random‐effects meta‐analyses showed improvements in child development (g = 0.30; 99% confidence interval [CI] = 0.07–0.53) and reduction in reported problem behaviors (g = 0.41; 99% CI = 0.24–0.59), but not a statistically significant improvement in adaptive behavior (g = 0.28; 99% CI = −0.42 to 0.98). Caregivers showed improvements in parenting skills and knowledge (g = 0.72; 99% CI = 0.53–0.90), psychological well‐being (g = 0.52; 99% CI = 0.34–0.71), and interpersonal family relations (g = 0.76; 99% CI = 0.32–1.20).
Interpretation
Caregiver skills training programs benefit both caregivers and children with neurodevelopmental disorders. Skills training programs improve child development and behavior, improve parenting skills, reduce caregiver mental health issues, and improve family functioning. Programs using culturally appropriate training material to improve the development, functioning, and participation of children within families and communities should be considered when caring for children with neurodevelopmental disorders.
What this paper adds
Caregiver skills training programs are effective interventions for both caregivers and children.
Children with neurodevelopmental disorders benefit from improvements in development and reduction of problematic behaviors.
Caregivers benefit from enhanced skills and psychological well‐being.
Improvements in interpersonal family relationships have also been documented.
ContextEarly intervention, and parent-mediated intervention are effective in achieving early childhood development goals for children with autism spectrum disorder. There is a surge in mHealth technologies delivering such interventions. This review aims to explore the concept, context and methodology of implementation of such mHealth apps.Evidence AcquisitionA search was conducted using NICE (National Institute of Clinical Excellence) healthcare database, including keyword ‘early intervention,’ ‘mHealth,’ ‘parent support,’ ‘apps,’ and ‘autism.’ The quantitative, qualitative, mixed-methods, case reports, grey literature, systematic reviews, clinical trials, and feasibility studies of children between 2 to 6 years with ASD were included from inception of database to December, 2021. Web/Internet-based or computer-dependent programs were excluded. The initial search yielded 3786 studies; 17 were finally included based on the inclusion and exclusion criteria.ResultStudies on a total of mhealth apps were reviewed. Nine apps, apart from TOBY (Therapy outcome by you), lacked a holistic approach and instead targeted a specific difficulty in autism. The provision of support to parents using apps was equally beneficial as in-person support, reduced costs, and improved outcomes in children.Conclusion
The review revealed limited evidence-based mHealth apps available currently in a community setting. This also underscores an opportunity for clinicians to re-direct parents towards evidence-based information and interventions.
The purpose of this study is to verify the effectiveness of an eclectic
counseling program for reducing future anxiety as an approach to improve
the enjoyment of life for a sample of mothers with special needs. The pilot
sample comprised 35 mothers of such individuals and the seven who had
the highest scores on the Future Anxiety were chosen as the basic sample
of the study, those who have the highest score on Future Anxiety scale. The
study used the Future Anxiety, Enjoyment of Life scales and a Counseling
Program that was based on Selective Counseling Theory. The results
showed the following.
There are significant differences between the pre- and post-test in
Future Anxiety and its subscales in favor of the pre-test, except for Health
and Death Anxiety. There are significant differences between the pre- and
post-test in the enjoyment of life in favor of the post-test. There are no
significant differences between the post- and follow-up test in Future
Anxiety and enjoyment of life.
Background
Adequate bowel preparation is an important colonoscopy quality indicator. Reinforced education is effective in improving bowel preparation quality of colonoscopy with mixed indications. However, it remains unclear whether such improvement can be consistently observed in pre- and post-irrigation during colonoscopy in screening population.
Objective
We aimed to study the effectiveness of nurse-led reinforced education delivered via mobile messenger (WhatsApp Messenger) on pre- and post-irrigation bowel preparation adequacy in colonoscopies for positive fecal immunochemical test in a population-based colorectal cancer screening program.
Design
Randomized controlled trial.
Setting
A hospital-based endoscopy centre in Hong Kong, China.
Participants
Patients undergoing colonoscopy for positive fecal immunochemical test in a population-based colorectal cancer screening program.
Methods
The recruited patients were randomized to receive either WhatsApp Reinforced Education (WRE) or No Reinforced Education (NRE) (1:1). Patients in WRE group received one-off reinforced education of bowel preparation in text and video formats via WhatsApp Messenger four days prior to colonoscopy sent by investigator while NRE group received standard-of-care only.
Primary outcome was the bowel preparation adequacy rate as evaluated by Aronchick Scale. Secondary outcomes included bowel preparation adequacy rate as evaluated by Boston Bowel Preparation Scale, adenoma detection rate and risk factors of bowel preparation inadequacy. Continuous variables were described as means with standard deviation (SD) and analyzed with Student's T Test. The Pearson Chi Square Test or Fisher Exact Test was used to assess categorical variables when appropriate. Risk factors were determined by logistic regression.
Results
From July 2017 to April 2019, 685 eligible patients were randomized to WRE (n = 343) and NRE (n = 342) groups. Patients in WRE group had higher bowel preparation adequacy rate as evaluated by Aronchik Scale (83.4% vs 75.4%, p = 0.010) and Boston Bowel Preparation Scale (94.2% vs 88.9%, p = 0.013). adenoma detection rate was higher in WRE group but without statistical significance (71.4% vs 67.5%, p = 0.27). In logistic regression, WhatsApp Reinforced Education reduced the inadequate bowel preparation risk (Adjusted odds ratio: 0.564; 95% confidence interval: 0.371–0.856, p = 0.007). Male gender (Adjusted odds ratio [AOR]: 1.638; 95% confidence interval [CI]: 1.054–2.546, p = 0.028) and diabetes (AOR: 2.062; 95% CI: 1.215–3.497, p = 0.007) were risk factors of bowel preparation inadequacy.
Conclusions
Nurse-led mobile messenger-initiated reinforced education improves both pre- and post-irrigation bowel preparation quality of screening colonoscopy following positive fecal immunochemical test. It is readily incorporable in clinical practice because of its low setup cost.
REGISTRATION NUMBER
Registered on 4 July 2017 on https://clinicaltrials.gov/ (NCT03209739).
Objective
Autism Spectrum Disorder (ASD) is a chronic neurodevelopmental disorder. Living with ASD requires that individuals and parents develop skills in order to cope with daily life. Education interventions are recommended to support them. This study aims to get an overview of education and training interventions in ASD.
Methods
A scoping review of international literature was conducted.
Results
43 articles were analyzed. Four main types of intervention stand out: support groups, parental training; psychoeducation; therapeutic patient education. However, the majority of publications is focused on the parents rather than on individuals living with ASD, and the needs assessments identified focused on general needs rather than educational needs.
Conclusion
While educational interventions for parents and individuals with ASD are now encouraged, considerable heterogeneity is observed. But this variety is not based on a reasoned approach to matching supply and needs. Future studies could focus more on the educational needs of individuals with ASD.
Practice Implications
Overview of education and training interventions in ASD help health care providers to better understand the strengths and limitations of their interventions.
Background
There is a well-established association between emotional and behavioral problems in children with Autism Spectrum Disorder (ASD), unmet family support needs, and psychological distress in their parents. However, no studies hypothesized a buffering effect of marital relationship satisfaction.
Aim
The aim of this research was to investigate the moderating effect of marital relationship satisfaction in the associations among emotional and behavioral problems in children with ASD, unmet family support needs, and anxiety and depression of their parents in the context of Saudi Arabia.
Design and methods
This cross-sectional study recruited parents from five rehabilitation centers for children with ASD in Saudi Arabia. Data were collected with surveys completed online. A sample of 93 parents (84% female, 4.3% were 24 or younger, 36.2% between 25 and 34 years old, 40.5% between 35 and 44, and 14.7% between 45 and 54) of children with ASD was obtained. Two models of multiple regression analysis were performed to determine the relationships.
Results
About 56% of the parents had anxiety symptoms and 60% had depressive symptoms. Emotional and behavioral problems of children and higher levels of unmet family support needs were associated with higher levels of anxiety in parents, and adaptive behavior of children was associated with reduced levels of depression in parents. Relationship satisfaction moderated the impact of children's emotional and behavioral problems on parental anxiety.
Conclusion and implications
The study highlighted the importance of marital relationship satisfaction in buffering the negative effects of ASD-related factors of children on the psychological well-being of their parents.
This meta-analysis examines the impact of parent interventions on outcomes for parents of children with ASD. A systematic review of the literature produced 37 studies that met inclusion criteria. Random-effects models revealed small but significant impacts of intervention on parental outcomes, primarily in parenting confidence and mental health. No improvements were observed in caregiving burden, family adjustment, physical health, or stress. Significant heterogeneity was observed; however, no moderation effects were detected for intervention or sample characteristics. These findings suggest parent interventions improve parenting confidence and, to a lesser degree, mental health. More work is needed to develop interventions that address a wider range of outcomes for parents of children with ASD. Limitations and implications for future research are discussed.
The purpose of this study is to verify the effectiveness of an eclectic counseling program for reducing future anxiety as an approach to improve the enjoyment of life for a sample of mothers with special needs. The pilot sample comprised 35 mothers of such individuals and the seven who had the highest scores on the Future Anxiety were chosen as the basic sample of the study, those who have the highest score on Future Anxiety scale. The study used the Future Anxiety, Enjoyment of Life scales and a Counseling Program that was based on Selective Counseling Theory. The results showed the following.
There are significant differences between the pre- and post-test in Future Anxiety and its subscales in favor of the pre-test, except for Health and Death Anxiety. There are significant differences between the pre- and post-test in the enjoyment of life in favor of the post-test. There are no significant differences between the post- and follow-up test in Future Anxiety and enjoyment of life.
Background
An updated systematic scoping review and narrative analysis of all possible mental health studies done during the concerned immediate years clarifies its present condition and status for all professionals, and concerned researchers.
Aims
To synthesize published mental health research studies in and for Saudi Arabia for the years 2009-2019 with the confidence to evaluate current situation, identify research gaps and limitations (if any), and assist in conceptualizing the forthcoming directions of future mental health research activities.
Methods
Scoping systematic review and modified narrative analysis were the methods utilized to achieve the aim and objective set for this formal academic endeavor.
Results
Of the 1,006 published studies identified from chosen databases, a total of 241 papers were included and had passed the stringent criteria set for the scoping review process. Basic characteristics of the reviewed studies were quantitative survey type with about 101-500 size range of respondents, utilizing non-patients and adults for participants which were common and randomly chosen from selected population, and most research activities were self-funded. Four major research themes were found including a list of research limitations.
Conclusions
This systematic scoping review identified a wide range of results characterizing the different studies that qualified using pre-determined inclusion-exclusion criteria. Though of increasing publication volume in the past decade, most researches done were quantitative survey type whose themes seemed to show no drastic difference or change from the previous years of output. More variety in research themes would further improve the over-all quality of mental health publications.
Background:
Parents of children with Autism Spectrum Disorder (ASD) experience considerable amounts of stress and impaired emotional well-being. Consequently, it is likely that these have been adversely impacted by COVID-19 outbreak due to disruptions to the schedules of children with ASD.
Aim:
This study investigated the stress and emotional well-being of parents of children with ASD in Saudi Arabia during the COVID-19 pandemic.
Method:
The study obtained quantitative data from 150 parents of children with ASD from different regions in Saudi Arabia using an online survey. The data collected included demographic data of the parents, ASD status of the family, ASD support during COVID-19 pandemic, severity of ASD behaviours in comparison to the pre- COVID-19 status eating behaviour of the child with ASD, Parental Stress, and emotional well-being. The PSI-short form (PSI-SF) (Abidin, 1995) scale was utilised to obtain data related to parental stress and the General Health Questionnaire (GHQ-12) (Goldberg, 1992) scale was utilised to obtain data related to parents' emotional well-being.
Results:
The study found that family ASD status (in particular, age and gender of child with ASD, and severity of his/her symptoms) had a significant impact on parental stress and emotional well-being. Moreover, parental stress and emotional well-being were negatively impacted by the frequency and usefulness of ASD support received during COVID-19 pandemic. These were also adversely impacted by the change in severity of ASD behaviours of the children with ASD. Finally, parental stress was found to have a negative impact on the emotional well-being of parents. Overall, the study found that the parental stress and emotional well-being of parents of children with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic.
Conclusions:
Overall, the study found that the parental stress and emotional well-being of parents with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic. This study recommends the involvement of the Saudi Ministry of Health to establish and extend support services to support parents of children with ASD. Moreover, the provision of training programs to help parents deal with the characteristic behaviour of their children with ASD such as, the ability to maintain routines, aggressive or repetitive behaviour, is also recommended.
Pendahuluan: Pola asuh orang tua sangat berpengaruh terhadap pertumbuhan dan perkembangan anak, apalagi jika pada anak mengalami autis. Umumnya orang tua yang memiliki anak autis mengalami stres, oleh karena itu bagaimana program pemberian parenting sangat penting dikaji agar orang tua dapat memperlakukan anak autis dalam mencapai perkembangan optimalnya. Systematic review ini bertujuan untuk menjelaskan pengaruh program parenting dalam mengurangi stres orang tua dengan anak autis.Metode: Pencarian jurnal dilakukan pada database Scopus dan Sience Direct, pembatasan jurnal pada 10 tahun terakhir mulai 2008-2017, area jurnal Nursing, Psychologi, Disabilitas, Child, dan Psychiatri dengan kata kunci Parenting, Parent Stress and Autism. Prosedur seleksi dan ekstraksi data menggunakan pendekatan PICOT.Hasil: Total keseluruhan partisipan dari seluruh penelitian yang diriview adalah 2107 dengan orangtua yang mengalami kecemasan atau stress akibat memiliki anak autis. Intervensi yang digunakan dalam semua penelitian adalah intervensi program parenting dan support parenting. Rerata durasi interfensi selama 3 minggu dengan rerata follow up 12 bulan. Efek signifikan ditemukan secara statistik dari program parenting atau support parenting untuk hasil pasca pemberian intervensi hingga follow up. Hasil yang signifikan ditemukan pada pemberian program parenting melalui media konseling peneliti di dampingi oleh terapis yang bersertifikat.Kesimpulan: Parenting memiliki pengaruh yang signifikan dalam menurunkan stres pada orang tua yang memiliki anak autis. ABSTRACTIntroduction: Parenting is very influential in the growth and development of children, especially if the child has autism. Generally, parents who have autistic children experience stress, therefore how the parenting program is very important to be studied so that parents can treat autistic children in achieving optimal development. This Systematic review aims to explain the effect of parenting programs in reducing the stress of parents with autistic children.Method: The journal search was conducted on the Scopus and Science Direct databases, journal restrictions in the last ten years starting 2008-2017, the journal areas of Nursing, Psychology, Disability, Child, and Psychiatry with the keywords Parenting, Parent Stress and Autism. Data selection and extraction procedures use the PICOT approach.Results: The total number of participants from all studies reviewed was 2107, with parents experiencing anxiety or stress due to having an autistic child. The interventions used in all research were parenting program interventions and parenting support. The average duration of intervention was three weeks with a mean follow-up of 12 months. Significant effects were found statistically from parenting programs or parenting support for outcomes post-intervention until follow-up. Significant results were found in parenting programs through researchers' counseling media accompanied by certified therapists.Conclusion: Parenting has a significant effect on reducing stress in parents who have autistic children.
Cultural dimensions of autism spectrum disorder (ASD) are relatively unexplored in the research literature. The current study is a systematic scoping review describing social, educational, and psychological research focused on individuals with ASD and their family members in Arab countries and cultures. Seventy studies met eligibility criteria. Most of the studies were from Jordan, Saudi Arabia, and Lebanon. Most of the identified research addressed three major domains: the prevalence of ASD and diagnosis issues, the experiences and outcomes for Arab caregivers of individuals with ASD, and social and communication behaviour of Arab individuals with ASD. There were significant gaps in research evidence base, including research on interventions and on ASD services. Overall, the included research was appraised as being of weak quality.
In this comprehensive systematic review and meta-analysis of group design studies of nonpharmacological early interventions designed for young children with autism spectrum disorder (ASD), we report summary effects across 7 early intervention types (behavioral, developmental, naturalistic developmental behavioral intervention [NDBI], TEACCH, sensory-based, animal-assisted, and technology-based), and 15 outcome categories indexing core and related ASD symptoms. A total of 1,615 effect sizes were gathered from 130 independent participant samples. A total of 6,240 participants, who ranged in age from 0-8 years, are represented across the studies. We synthesized effects within intervention and outcome type using a robust variance estimation approach to account for the nesting of effect sizes within studies. We also tracked study quality indicators, and report an additional set of summary effect sizes that restrict included studies to those meeting prespecified quality indicators. Finally, we conducted moderator analyses to evaluate whether summary effects across intervention types were larger for proximal as compared with distal effects, and for context-bound as compared to generalized effects. We found that when study quality indicators were not taken into account, significant positive effects were found for behavioral, developmental, and NDBI intervention types. When effect size estimation was limited to studies with randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and NDBI intervention types. This was also the case when outcomes measured by parent report were excluded. Finally, when effect estimation was limited to RCT designs and to outcomes for which there was no risk of detection bias, no intervention types showed significant effects on any outcome. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
With online education and programs becoming increasingly common, it is necessary to examine their effectiveness. In this study, we conduct a meta-analysis of online parenting programs. In this meta-analysis, we included 28 studies yielding 127 effect sizes examining 15 outcome variables. We found that online parenting programs had the strongest effects on increasing positive parenting and parents' encouragement. We also found significant effects of reducing negative parent-child interactions, child problem behaviors, negative discipline strategies, parenting conflicts, parent stress, child anxiety, parent anger, and parent depression. Results also revealed programs' significant effects on increasing parent confidence, positive child behavior and parenting satisfaction. Comparisons of programs that included clinical support (meaning programs through which participants had access to content experts, therapists, or content specialists in conjunction with the online program) versus programs that only contained online components, revealed no significant differences in 6 program outcomes between programs with and without clinical support. Comparisons of programs provided to targeted populations versus general populations revealed no significant differences in four program outcomes between populations. Results suggest that online parenting programs can provide benefits for parents who may not be able to access in-person resources. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Objective
Youth mental health problems have been identified as a major public health concern. However, there are a number of parent populations that remain under‐engaged with face‐to‐face parenting programs, which include fathers, and parents of lower socioeconomic position and rural location. This review aimed to evaluate the evidence for technology‐assisted parenting programs for youth mental health and parenting outcomes; as well as the extent to which they engage underserved parent populations and how they can be better tailored for these groups in an Australian context.
Methods
Employing the PRISMA method, we conducted a systematic review of randomised controlled trials of technology‐assisted parenting programs for youth mental health problems.
Results
We identified 47 articles that met inclusion criteria, consisting of 25 randomised controlled trials along with 8 and 14 articles describing intervention development and follow‐up, respectively. Some evidence was found to support the use of technology‐assisted parenting programs, particularly to improve externalising problems and parenting skills. Additionally, program development and recruitment strategies to engage underserved parents were under‐utilised among studies reviewed.
Conclusions
Findings from this review indicate that technology‐assisted parenting programs may present an effective alternative to traditional face‐to‐face programs. However, more comprehensive and evidence‐based strategies are required for program development and recruitment to capitalise on the advantages of technology‐assisted programs to enhance engagement with underserved parent populations. Further research should investigate program attributes and engagement strategies for diverse parent populations.
This conceptual paper reviews the need for a family-focused service delivery model within the autism spectrum disorder (ASD) field and suggests that the Double ABCX Model of Stress and Adaptation is a way to address this need. Within the ASD field, there is an absence of service delivery models that are able to address the needs of the family as a unit, rather than the individual child with ASD. This gap is striking given the reciprocal relationship between parent and child outcomes within the ASD field. To support our argument that the Double ABCX model could be used to integrate parent and child-focused interventions within the ASD field, this paper starts by reviewing the mental health outcomes often associated with having a child with ASD. We next provide a historical overview of the Double ABCX model and review a body of ASD intervention literature within the context of the Double ABCX model framework. Doing so shows that a number of child and parent focused interventions within the ASD field can be fit within the Double ABCX framework. However, a handful of methodological and sampling limitations prevent the Double ABCX model from being fully supported as a model that could be applied in a variety of settings. Taken together, this review highlights that the Double ABCX model is a promising strategy to integrate child and parent-focused interventions within the ASD field, but highlights that specific areas of future research are needed in order to build continued support for this argument.
This pilot RCT compared the effect of a self-directed and therapist-assisted telehealth-based parent-mediated intervention for young children with ASD. Families were randomly assigned to a self-directed or therapist-assisted program. Parents in both groups improved their intervention fidelity, self-efficacy, stress, and positive perceptions of their child; however, the therapist-assisted group had greater gains in parent fidelity and positive perceptions of child. Children in both groups improved on language measures, with a trend towards greater gains during a parent-child interaction for the therapist-assisted group. Only the children in the therapist-assisted group improved in social skills. Both models show promise for delivering parent-mediated intervention; however, therapist assistance provided an added benefit for some outcomes. A full-scale comparative efficacy trial is warranted.
There are few happiness measures in Arabic. The purpose of this study was to construct and validate the Arabic Scale of Happiness as a trait measure, suitable for college students and adolescents. The scale comprised 15 brief statements plus five filler items. Each item was answered on a 5-point intensity scale. The total score could range from 15 to 75, with higher scores indicating higher happiness. A principal axis factor analysis followed with oblique rotation (pattern and structure matrices) yielded two factors labeled: General happiness and Successful life. Item-rest-of-test correlations ranged from .42 to .77. Cronbach's alphas and test-retest reliabilities ranged from .82 to .94, indicating good internal consistency and temporal stability. The construct validity of the scale ranged between .55 and .79 against the Fordyce Happiness Measure, the Subjective Happiness Scale, and the Oxford Happiness Inventory. The Arabic Scale of Happiness statistically significantly correlated with mental health, satisfaction with life, optimism, love of life, and self-esteem, so construct validity was adequately demonstrated. Male college and high school students obtained higher mean scores than did their female counterparts. Male and female undergraduates obtained higher mean scores than did their adolescent counterparts. It was concluded that the Arabic Scale of Happiness has good psychometric properties. The scale has an English equivalent version.
This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for this methodology are proposed.
Foreword This guide was produced following an Improving Access to Psychological Therapies (IAPT) Conference held at the Queens Hotel in Leeds in February 2009. The conference had been organised in response to feedback from services and those attending training courses expressing a need for expert guidance on the use of self-help materials given the wide range of different materials and media all purporting to offer helpful advice and information to people about a range of problems and disorders. A conference was organised with expert researchers and practitioners who had experience of developing self-help materials in order to discuss whether guidance should be forthcoming and in which form it should take. Rather than endorsing particular self-help materials that are available, the conference focused on attempting to derive a set of criteria by which both practitioners and people might be able to assess the utility and effectiveness of particular materials. It was agreed that these principles might provide the basis for a 'Good Practice Guide' about how to choose and use self-help materials.
Digital technology has the potential to transform mental healthcare by connecting patients, services and health data in new ways. Digital online and mobile applications can offer patients greater access to information and services and enhance clinical management and early intervention through access to real-time patient data. However, substantial gaps exist in the evidence base underlying these technologies. Greater patient and clinician involvement is needed to evaluate digital technologies and ensure they target unmet needs, maintain public trust and improve clinical outcomes.
Royal College of Psychiatrists.
Objective: This randomized controlled trial evaluated the efficacy of Primary Care Stepping Stones Triple P, a brief individualized parenting program, in a sample of parents of children with autism spectrum disorder (ASD). Method: Sixty-four parents of children aged 2–9 years (M = 5.67, SD = 2.14) with an ASD diagnosis participated in the study. Eighty-six percent of children were male, and 89% of parents identified their child’s ethnicity as Australian/White. Families were randomly assigned to 1 of 2 conditions (intervention or care-as-usual) and were assessed at 3 time points (preintervention, postintervention, and 6-month follow-up). Parents completed a range of questionnaires to assess changes in child behavior (Eyberg Child Behavior Inventory) and parent outcomes (Parenting Scale, Depression Anxiety Stress Scale–21, Parent Problem Checklist, Relationship Quality Inventory, Parental Stress Scale) and 30-min home observations of parent–child interactions. Results: Relative to the care-as-usual group, significant short-term improvements were found in the intervention group on parent-reported child behavior problems, dysfunctional parenting styles, parenting confidence, and parental stress, parental conflict, and relationship happiness. No significant intervention effects were found on levels of parental depression or anxiety, or on observed child disruptive and parent aversive behavior. The effect sizes for significant variables ranged from medium to large. Short-term effects were predominantly maintained at 6-month follow-up, and parents reported high levels of goal achievement and satisfaction with the program. Conclusions: The results indicate that a brief low intensity version of Stepping Stones Triple P is an efficacious intervention for parents of children with ASD.
Parents of children with autism report high levels of stress as compared to parents of typically developing children, children with chronic illnesses, and children with other developmental disabilities. Previous research has supported both parent-focused and child-focused parent training programs as effective in alleviating parental stress and enhancing meaningful parent–child interactions. In the present study, a behavioral skills approach was compared to a parent-oriented model, a mindfulness group. Fifteen parents of children with autism were matched on a measure of parental stress and were randomized to one of the two treatment groups. Each group included an 8-week program that incorporated didactics, discussion, role plays, and homework. Parental stress and global health outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up. Overall, the mindfulness group alone demonstrated statistically significant improvement on both outcome measures following treatment. Although significant changes were not observed in the skills group, effect sizes suggested moderate to large treatment benefits. The feasibility of the programs as well as implications and future directions of this line of research are discussed.
Parent training has been shown to be a very effective method for promoting generalization and maintenance of skills in children with autism. However, despite its well-established benefits, few public school programs include parent training as part of the early childhood special education (ECSE) curriculum. Barriers to the provision of parent training include the need for parent education models that can be easily implemented in ECSE programs and the need for preparation of special educators in parent education strategies. This article describes a parent training model for children with autism developed for use in ECSE programs. The implementation of the program, teacher preparation, and preliminary outcomes and challenges will be discussed.
To evaluate the presence of depression and anxiety in parents/caregivers of autistic spectral disorder (ASD) children, and to identify associated factors.
In this retrospective cohort study carried out between July and December 2011, parents/caregivers of at least one child diagnosed with an ASD (cases group), were recruited through the Saudi Charitable Society of Autism Families and the Autism Clinic in the Pediatric out-patient clinic in King Fahad National Guard Hospital, King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. The parents/caregivers of a normally developed child (control group) were recruited from the Well Child Clinic at King Abdulaziz Medical City, Riyadh. We used a self-reported questionnaire containing questions on demographic data, as well as the Arabic version of the hospital anxiety and depression scale.
The study included 100 parents/caregivers, 50 cases and 50 controls. More than 50% of the control group was in the age group 26-30 years (56%), while 42% of cases were in the age group 31-35 years. Time lapsed since autism diagnosis was over 3 years in one-third of cases. Twenty-two percent of cases, and only 2% of control parents/caregivers had a history of psychiatric problems (p=0.002). Both the mean depression score, and the mean anxiety score was significantly higher among cases when compared with controls, p<0.001.
Autism is associated with burden and stress for parents/caregivers of the affected child. The demands placed by the disability contribute to a higher overall incidence of depression and anxiety among parents/caregivers.
Assessed the impact of psychoeducation intervention on the depressive symptoms of 28 mothers of young children with autism or related disorders (aged 2–6 yrs). Mothers in 2 demographically comparable treatment and no-treatment groups completed the Center for Epidemiologic Studies Depression Scale at the time of the child's diagnosis, and at 6 and 18 mo later. Repeated measures ANOVA procedures revealed a significant treatment time interaction. Mothers who participated in the psychoeducational treatment program decreased in depressive symptoms over time, and mothers without treatment showed no change over time. Results are discussed in terms of understanding maternal depression in most of these families as a modifiable adjustment reaction to the stress of caring for a child with a chronic disability. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.
Whilst the Triple P Positive Parenting Program has a large evidence base (Sanders, Clinical Child and Family Psychology Review
2:71–90, 1999; Sanders, Journal of Consulting and Clinical Psychology 68:624–640, 2000) and preliminary evidence indicates that Stepping Stones Triple P is also efficacious (Roberts, Journal of Clinical Child
and Adolescent Psychology, 35(2):180–193, 2006), to date Stepping Stones has not been evaluated with the ASD population. Fifty-nine families with a child with ASD aged
between 2 and 9 participated in this randomized controlled trial. The results demonstrate significant improvements in parental
reports of child behaviour and parenting styles with the treatment effects for child behaviour, parental over reactivity and
parental verbosity being maintained at follow-up 6months later. Further, the results suggest significant improvements in
parental satisfaction and conflict about parenting as well as a sleeper effect for parental efficacy. The results indicate
that Stepping Stones Triple P is a promising intervention for parents of children with ASD. Limitations and future research
are also addressed.
Parents of children with Autism Spectrum Disorders (ASD) generally experience high levels of stress and report poorer emotional well-being and family functioning compared to parents of children with other disabilities. They also tend to rely on emotional rather than problem-focused coping strategies. Seven group-based sessions were offered to two groups of parents of children with ASD in Iran (37 in all). In addition to providing information about ASD emphasis was placed on families sharing their experiences and learning from one another. A pre-post, cross-over design was used to evaluate the specific impact of the course. The changes found among the parents in the first group were replicated with the second group. Moreover the changes were sustained up to 15 weeks after the course ended. Although there were variations across the parents, in general they reported feeling less stress, had better emotional wellbeing and family functioning and made more use of problem-focused coping strategies. The changes were attributed mainly to an increase in the informal supports among the parents and their feelings of empowerment. A resource pack has been developed to enable the group sessions to be easily repeated and for facilitators to be trained in its use.
Parents of children with autism report high rates of stress. Parental differences in stress are inconsistent, with most research indicating that mothers report higher levels of stress than fathers. We explored parental differences before and after an in-home training program. Fathers were taught an intervention designed to improve their child's social reciprocity and communication; they then trained mothers. Stress was assessed with the Parenting Stress Index-Short Form, and family dynamics was assessed with the Family Adaptability and Cohesion Evaluation Scales II. Both mothers and fathers reported high preintervention levels of stress. After intervention, fathers' stress was reduced, but not significantly, possibly because of the variability in fathers' scores; mothers' stress scores were significantly reduced. Parenting styles were significantly different before and after intervention. Interdisciplinary teams, including occupational therapists, nurses, and special educators, can work.together to have a positive impact on the lives of families of children with autism.
Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families.
One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for 8 standard statistical tests: (1) the difference between independent means, (2) the significance of a product-moment correlation, (3) the difference between independent rs, (4) the sign test, (5) the difference between independent proportions, (6) chi-square tests for goodness of fit and contingency tables, (7) 1-way analysis of variance (ANOVA), and (8) the significance of a multiple or multiple partial correlation.
Parents of children with developmental disabilities, particularly autism spectrum disorders (ASDs), are at risk for high levels of distress. The factors contributing to this are unclear. This study investigated how child characteristics influence maternal parenting stress and psychological distress. Participants consisted of mothers and developmental-age matched preschool-aged children with ASD (N = 51) and developmental delay without autism (DD) ( N = 22). Evidence for higher levels of parenting stress and psychological distress was found in mothers in the ASD group compared to the DD group. Children's problem behavior was associated with increased parenting stress and psychological distress in mothers in the ASD and DD groups. This relationship was stronger in the DD group. Daily living skills were not related to parenting stress or psychological distress. Results suggest clinical services aiming to support parents should include a focus on reducing problem behaviors in children with developmental disabilities.
Stress proliferation (the tendency for stressors to create additional stressors) has been suggested as an important contributor to depression among caregivers. The present study utilized longitudinal data from 90 parents of children with ASD to replicate and extend a prior cross-sectional study on stress proliferation by Benson (J Autism Develop Disord 36:685-695, 2006). Consistent with Benson's earlier findings, regression analyses indicated that stress proliferation mediated the effect of child symptom severity on parent depression. Parent anger was also found to mediate the effect of symptom severity on stress proliferation as well as the effect of stress proliferation on parent depression. Finally, informal social support was found to be related to decreased parent depressed mood over time. Implications of study findings are discussed.
In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.
Distinguishing between depression and anxiety has been a matter of concern and controversy for some time. Studies in normal samples have suggested, however, that assessment of two broad mood factors—Negative Affect (NA) and Positive Affect (PA)—may improve their differentiation. The present study extends these findings to a clinical sample. As part of an ongoing twin study, 90 inpatient probands and 60 cotwins were interviewed with the anxiety and depression sections of the Diagnostic Interview Schedule (DIS; Robins, Helzer, Croughan, & Ratcliff, 1981). Respondents also completed trait NA and PA scales. Consistent with previous research, NA was broadly correlated with symptoms and diagnoses of both anxiety and depression, and acted as a general predictor of psychiatric disorder. In contrast, PA was consistently related (negatively) only to symptoms and diagnoses of depression, indicating that the loss of pleasurable engagement is a distinctive feature of depression. The results suggest that strengthening the PA component in depression measures may enhance their discriminative power.
The hierarchy of evidence in assessing the effectiveness of interventions or treatments is explained, and the gold standard for evaluating the effectiveness of interventions, the randomised controlled trial, is discussed. Issues that need to be considered during the critical appraisal of randomised controlled trials, such as assessing the validity of trial methodology and the magnitude and precision of the treatment effect, and deciding on the applicability of research results, are discussed. Important terminologies such as randomisation, allocation concealment, blinding, intention to treat, p values, and confidence intervals are explained.
Two 9-to 10-month-long studies (N = 137) examined the interaction between parenting stress and behavior problems in children with autistic spectrum disorders (ASDs). Study 1 focused on very young children, and Study 2 employed a wider range of child ages; both studies assessed these factors at 2 points in time. The researchers noted a strong association between parenting stress and child behavior problems when they controlled for other factors, such as ASD severity and intellectual functioning (Study 1 and 2). However, Study 1 indicated that when the children were very young (2:6-4:0 years), ASD severity related most strongly to parenting stress. In addition, both Study 1 and Study 2 indicated that parenting stress at Time 1 was a stronger predictor of child behavior problems at Time 2, rather than vice versa.
This study was conducted to examine the effectiveness of a parent education program on decreasing parenting stress and increasing parental confidence and quality of life in parents of Chinese American children with autism spectrum disorders (ASDs). A pre-, posttest group design was used in this study. A total of nine families of Chinese American children with ASDs participated in a 10-week parent education program (including 10-weekly 120-min group sessions). The findings of this study revealed that after receiving the program, parents of Chinese American children with ASDs showed significant reduction in parenting stress, improvement in parental confidence, and improvement in quality of life in physical health and environment domains.
Abstract Few research studies have explored how the level of a child's behavior problems leads to psychological distress in parents of children with autism. The authors explored whether psychological acceptance and mindfulness mediated this relationship between child behavior and parental distress. Seventy-one mothers and 39 fathers of children with autism participated, by reporting on their own positive and negative psychological well-being and their child's behavior problems. Psychological acceptance was found to act as a mediator variable for maternal anxiety, depression, and stress, and for paternal depression. General mindfulness and mindful parenting had significant mediation effects for maternal anxiety, depression, and stress. These results contribute to evidence that mindfulness and acceptance may be important parental psychological processes, with implications for parent support.
Abstract: The field of augmentative and alternative communication (AAC) continues to struggle with issues relating to generalization and maintenance. Current methods of modifying instructional practices and teaching skills directly to the communication partner have contributed to developing successful treatment outcomes. However, few studies have examined AAC in the home setting during daily routines with parents. This study examined whether teaching parents a problem-solving intervention that considered the family's lifestyle would promote child spontaneous picture card use and parent-provided communication opportunities during daily routines. Data were collected in the context of a multiple baseline design across child and parent behavior. The results showed increases in the child's use of cards and in the parent's use of communication opportunities across multiple routines, parent and child behavior maintenance over time, and increases in the parent's perception of their child's communication skill and of their own ability to promote communication. The findings support the use of a problem-solving intervention that incorporates the family's lifestyle as a method to promote augmentative communication during daily routines.
Background: Parents of children with intellectual disabilities are at increased risk for stress and other mental health problems. The purpose of the present review is to consider the evidence base for psychological intervention to remediate stress in these parents.
Methods: A selective review of interventions designed to reduce stress in parents of children with intellectual disabilities, with a focus on group interventions that incorporate various cognitive behavioural techniques.
Results: Research evidence suggests that standard service models (e.g., respite care, case management) probably help to reduce parental stress. The strongest evidence base is for cognitive behavioural group interventions, especially for the reduction of stress in mothers. Some data also indicate the potential value of parent‐led support networks.
Conclusions: More research and clinical development are needed to establish a firmer evidence base for stress interventions with parents of children with intellectual disabilities. There are also a number of potential practical implications of reducing parental stress for maximising the efficacy of general parent training interventions and also behavioural programmes for children's challenging behaviours.
ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
This study investigated the coping differences in relation to the psychosocial adjustment (depression, anxiety, and marital
adjustment) between mothers and fathers of children with and without High Functioning Autism Spectrum Disorders (HFASDs).
Forty-eight parents of children with HFASDs and 26 parents of children without any disability completed a packet of psychological
survey. Statistically significant differences were found between the HFASDs and control groups in depression, anxiety, one
subscale of the marital adjustment measure and four subscales of the coping measures. When compared across gender within the
HFASDs group, depression, anxiety, one subscale of the marital adjustment, and four subscales of coping were found to be statistically
significant. Parents of children with HFASDs exhibited less adaptive coping skills as compared to parents of children without
any disability. Mothers of children with HFASDs exhibited more adaptive coping skills as compared to their father counterparts.
Interaction effect of disability and gender, however, was not significant.
Research has shown that parents of children with special health care needs experience more parenting stress than parents of
typically developing children, but the relation between the type of disability and parenting stress is far from clear (Stein
1988; Tew and Lawrence 1975; Breslau et al. 1982; Miller et al. 1992). To explore the relation between the type of disability and parenting stress, parenting stress data on the Parenting
Stress Index (PSI) (Abidin 1995) and demographic information were collected from convenience samples of parents of four cohorts
of children: children with ADHD, children with developmental disabilities, children with HIV infection and children with asthma,
and typically developing children. Parents of children with attention deficit hyperactivity disorder (ADHD) and parents of
children with developmental disabilities (DD) reported higher total stress than parents of HIV-infected, asthmatic, and typically
developing children. Ethnicity did not explain any of the group differences, but caregiver’s language, education, employment
status, and overall life stresses explained some of the group differences in parent-related domains. Level of stress in parents
of children with special needs is determined by overall nature of the disorder, with the parents of children with ADHD and
developmental disorders reporting higher levels of parenting stress than children with HIV infection, asthma, and healthy
controls.
This study assessed the effectiveness of a targeted 9-week parent stress management program (PSM) on the parenting stress, mood, family functioning, parenting style, locus of control, and perceived social support of parents of children diagnosed with DSM-IV ADHD. Sixty-three parents from 42 families were randomly assigned to 1 of 2 conditions: immediate treatment or wait-list control. Results of the randomized control trial showed that for mothers, completion of the PSM program was accompanied by significant reductions in parent-domain parenting stress together with significant improvements in parenting style (verbosity, laxness, overreactivity). For fathers, completion of the program was associated with a reduction in verbosity only. Anonymously completed consumer satisfaction questionnaires demonstrated a high degree of satisfaction with the PSM program.
This paper reports on the effects of two types of parent-focused intervention, for parents of children with autism spectrum disorder (ASD) aged 2–4 years and within 6 months of diagnosis, on parent's perceptions of stress and competence. Interventions aimed to decrease parenting stress and increase parenting competence by embedding empirically supported parenting strategies within family routines. Families were assigned to a professionally supported intervention that included a workshop and 10 home-visits (n = 17) or to a self-directed video based intervention (n = 22). Development in social communication was greater for children of families receiving professional support as measured by a caregiver questionnaire but not on a clinically measured behavior sample. Improvements in adaptive behavior were greater for children in the professionally supported intervention when relatively low adaptive behavior scores had been demonstrated at pre-intervention. The professionally supported intervention resulted in reduced child-related parenting stress and increased parenting self-efficacy relative to the self-directed intervention. The findings support the importance of providing individualized information and professional support around the time of diagnosis for families who have a child with ASD.
The parenting experiences of mothers in a family with a child with autism spectrum disorder (ASD) and a typically developing (TD) child were studied using a qualitative analysis of mothers’ perceptions of the impact of autism on family and personal life. An additional quantitative comparison was performed to evaluate the effect of ASD on mothers’ parenting cognitions about their other, TD child. Mothers differentiated clearly in parenting cognitions about their child with ASD and about their TD child. Strong associations were found between mothers’ symptoms of stress and depression, and their parenting cognitions about both their children. To maximize intervention outcome, family interventionists should consider parenting experiences and should become aware of interfering maternal feelings and cognitions, such as guilt or low parental self-efficacy beliefs.
Because stress implies a particular kind of commerce between a person (or animal) and environment, it provides an ideal vehicle for addressing the subject matter of this book on internal and external determinants of behavior. We believe this issue is expressed especially well by differentiating between two metatheoretical concepts, transaction and interaction. We have been drawn inexorably toward an emphasis on transaction by the very nature of stress phenomena and the evolving theoretical perspective within which we have worked.
Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being.
The purpose of this paper is to describe the sources of parenting stress in mothers of children with Autism Spectrum Disorders (ASD) and examine the relationship between parenting stress and maternal psychological status (depression and well-being).
A descriptive correlational design was used. Data were collected via mailed questionnaires.
Behavioral symptoms were the primary source of parenting stress for mothers. There was no relationship between child characteristics and parenting stress. Mothers reporting more parenting stress had more depressive symptoms and lower levels of well-being.
Our findings have implications for interventions with mothers to help them manage their children's behavior and focus on stress reduction and well-being.
A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
A novel behavioural screening questionnaire, the Strengths and Difficulties Questionnaire (SDQ), was administered along with Rutter questionnaires to parents and teachers of 403 children drawn from dental and psychiatric clinics. Scores derived from the SDQ and Rutter questionnaires were highly correlated; parent-teacher correlations for the two sets of measures were comparable or favoured the SDQ. The two sets of measures did not differ in their ability to discriminate between psychiatric and dental clinic attenders. These preliminary findings suggest that the SDQ functions as well as the Rutter questionnaires while offering the following additional advantages: a focus on strengths as well as difficulties; better coverage of inattention, peer relationships, and prosocial behaviour; a shorter format; and a single form suitable for both parents and teachers, perhaps thereby increasing parent-teacher correlations.
This study was a trial of an intervention programme aimed to improve parental self-efficacy in the management of problem behaviours associated with Asperger syndrome. The intervention was compared across two formats, a 1 day workshop and six individual sessions, and also with a non-intervention control group. The results indicated that, compared with the control group, parents in both intervention groups reported fewer problem behaviours and increased self-efficacy following the interventions, at both 4 weeks and 3 months follow-up. The results also showed a difference in self-efficacy between mothers and fathers, with mothers reporting a significantly greater increase in self-efficacy following intervention than fathers. There was no significant difference between the workshop format and the individual sessions.
Parents of children with intellectual disabilities are at increased risk for stress and other mental health problems. The purpose of the present review is to consider the evidence base for psychological intervention to remediate stress in these parents.
A selective review of interventions designed to reduce stress in parents of children with intellectual disabilities, with a focus on group interventions that incorporate various cognitive behavioural techniques.
Research evidence suggests that standard service models (e.g., respite care, case management) probably help to reduce parental stress. The strongest evidence base is for cognitive behavioural group interventions, especially for the reduction of stress in mothers. Some data also indicate the potential value of parent-led support networks.
More research and clinical development are needed to establish a firmer evidence base for stress interventions with parents of children with intellectual disabilities. There are also a number of potential practical implications of reducing parental stress for maximising the efficacy of general parent training interventions and also behavioural programmes for children's challenging behaviours.
Mamlakah Alarabia Alsaudia https://slpemad.files.wordpress.com
- Y Al-Shodokhi
- A Al-Jabr
Studying autism and related developmental disorders
- A. Al Jarallah
- T. Al Waznah
- S. Al Ansari
- M. Al Hazmi
Al Daleel Al Shamel Le Khadmat Al Tawahod Bi Al Mamlakah Alarabia Alsaudia
- Y. Al-Shodokhi
- A. Al-Jabr
Parenting stress index: Professional manual
- R. R. Abidin
Intervention and support for parents and carers of Children and young people on the autism spectrum: A resource for trainers
- B. Wright
- C. Williams
Autism spectrum disorders: Interventions and treatments for children and youth
- R. L. Simpson
- S. R. De Boer-Ott