Online Program

Improving maternal mental health after a child's diagnosis autism spectrum disorder: Results from a randomized controlled trial

Tuesday, November 5, 2013 : 12:50 p.m. - 1:10 p.m.

Emily Feinberg, ScD, CPNP, Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
Zhandra Ferreira-Cesar, MPH, Community Health Sciences, Boston University School of Public Health, Boston, MA
Howard Cabral, PhD, MPH, Department of Biostatistics, Boston University School of Public Health, Boston, MA
Michael Silverstein, MD, MPH, Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA
Mothers of children with autism report high levels of pyschological distress. In a randomized controlled trial, we investigated whether a brief cognitive behavioral intervention, Problem Solving Education (PSE), decreased maternal depressive symptoms and parental stress during the period immediately following a child's diagnosis of autism. Participants were mothers of 120 children (mean age 34 months), recently diagnosed with autism. Intervention group participants received 6 sessions of manualized PSE, delivered in 30-minute individualized sessions. The study was conducted in an autism specialty clinic and six community-based early intervention programs that serve ethnically diverse, primarily low-income families. Families were followed over 9 months of follow-up; in this analysis, we report 3-month, immediate post-diagnosis outcomes. Primary outcomes were depressive symptoms, assessed using the Quick Inventory of Depressive Symptoms, and parental stress, assessed using the Parenting Stress Index. Fifty-nine mothers were randomized to receive PSE; 61 were randomized to usual care. Treatment adherence was high; 70% of intervention mothers received the full PSE course. At the 3 month follow-up assessment, PSE mothers were less likely than controls to have clinically significant depressive symptoms (6% vs. 22%; OR 0.21, 95% CI 0.05,0.78) and clinically significant parental stress (4% vs. 29%; OR 0.09, 95% CI 0.02,0.43). PSE demonstrated positive effect on maternal mental health during the critical post-diagnosis period when parents are asked to navigate a complex service delivery system for their children newly diagnosed with autism. Further work will follow these families for a total of 9 months to determine if such benefits are sustained.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
Describe the research documenting the effects of having a child with autism on maternal mental health Describe gaps in the research analyzing interventions to support the mental health of mothers of children with autism Discuss the results of a clinical trial that tested the a brief cognitive behavior intervention to prevent and attenuate maternal depressive symptoms

Keyword(s): Depression, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for design, implementation, and oversight of this study. I wrote the grant to the Maternal and Child Health Bureau that funded the study. I have a doctoral degreee in maternal and child health and advanced training in conduct of clinical trials.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.