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

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.