Study finds lower stress, depression levels in mothers of children with autism by improving relationships

Mothers of young children with autism who focus on improving the quality of their own relationship skills—as opposed to teaching developmental skills to their children—experience dramatic improvements in their level of parenting stress and depression.

That's according to a new research study involving Case Western Reserve University.

The study, co-authored by Gerald Mahoney, the Verna Houck Motto Professor of Families and Communities and associate dean for research and training at the Jack, Joseph and Morton Mandel School of Applied Social Sciences, examined the effects of this technique in a small experimental research study involving 28 preschool-aged children with autism and their parents in Saudi Arabia.

One focus of the study was to examine whether mothers' high stress and depression levels might improve based on their level of responsiveness in daily interactions with their children.

"Saudi Arabia is a country where there are not a lot of services for young children with disabilities," Mahoney said. "We wanted to examine the effects of this low-cost intervention strategy that focused on improving the quality of parents' involvement with their children and evaluate the effects of this intervention on both children and their parents."

Mahoney was joined in this study by a team of researchers from King Saud University and King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia.

Autism is a disability not only affecting child development, but also interfering with children's ability to engage in social interaction with their parents and others. Parents of children with autism commonly report extremely high levels of parenting stress and depression not only when their children are young but continuing throughout childhood.

Mahoney said that "parents of autistic children in Saudi Arabia are generally not involved with intervention services there, while parent involvement is a major focus of early intervention services in the United States and elsewhere."

So focusing on improving mother/child relationships made sense, he said.

Mahoney said the strategy worked.

At the beginning of this four-month study, all parents reported clinical levels of stress, and 70 percent reported clinical levels of depression. By the end of the research, the percentage of parents who received responsive teaching experiencing clinical levels of stress dropped to 30 percent; and the percentage of parents experiencing clinical levels of depression dropped to 15 percent. In comparison, there were no improvements reported for parents in the control group receiving no treatment.

In addition, children of parents receiving responsive teaching made significant developmental improvements as well: 44 percent attained better social skills; 37 percent improved language development; and 24 percent enhanced fine motor skills compared to children in the control group.

These findings were recently published in the International Journal of Disability, Development and Education.

"Although this was a small sample, we can say that this research was quite successful," said Mahoney, who has spent decades researching interventions for children with disabilities. "By changing the intervention to a relationship focused approach, we found that mothers' depression and stress dropped dramatically."

Responsive Teaching

Mahoney, along with Frida Perales, who received her doctoral degree in social welfare from the Mandel School, recently published a book about responsive teaching, appropriately titled Responsive Teaching: Relationship Based Developmental Intervention.

Responsive teaching is an evidence-based developmental curriculum designed for early intervention professionals who work with parents and caregivers to support and enhance their children's development in their natural environment.

The book, published by Lulu Publishing, stems from research investigating how parents' interactive relationships are associated with the development and well-being of children with developmental disabilities and risks.

It includes detailed instructional strategies, procedures, and session plans for addressing children's needs across three developmental domains: cognition, communication, and social emotional functioning.

For example, rather than encouraging parents to directly teach their children the communication and play skills that characterize their developmental delays—commonly practiced in early developmental intervention. The method focuses on encouraging parents to teach children skills, including: to take a turn and wait; act as a playful partner; and respond immediately to a child's play in communication behaviors.