CBT for Autistic Children Linked to Improved Parenting Practices and Mindfulness

Participation in cognitive behavior therapy (CBT) for autistic children in a community setting is associated with improved parenting practices and mindful parenting, though no significant changes in parent mental health have been observed, according to a study published in Autism Research.

While CBT interventions primarily target a child’s emotional regulation, researchers aimed to assess whether parental involvement in these programs yields additional benefits for parents. They examined changes in parent mental health, mindful parenting, and parenting practices following a community-based CBT program for autistic children.

The researchers conducted a cohort study involving 77 parent-child dyads recruited from 7 community organizations across Ontario, Canada. The intervention consisted of a virtual CBT-based program focused on enhancing children’s emotional regulation and social skills. Parents participated in concurrent sessions designed to support their child’s therapy implementation at home. Main outcomes included parental mental health challenges, measured by the Depression Anxiety Stress Scale (DASS-21); mindful parenting, measured by the Bangor Mindful Parenting Scale (BMPS); and parenting approaches, measured by the Parenting and Family Adjustment Scales (PAFAS). Child outcomes were a child’s social functioning, measured by the Social Responsiveness Scale (SRS-2) and their emotional regulation, measured by the Emotion Dysregulation Invention.

Most participating parents were mothers (95%) with a mean (SD) age of 42.5 (5.71) years, while children were primarily male (79%) with a mean (SD) age of 9.9 (1.28) years.

Post-intervention analysis demonstrated significant improvements in mindful parenting, with the mean score increasing from 32.4 to 33.9 (P<.001, d =-.40). Significant gains were observed in the subscales of non-reactivity (P<.001, d=-.40) and non-judgment (P=.002, d=-.38). Parenting practices also improved, evidenced by a reduction in coercive behaviors (P =.024, d =.26) and a rise in positive encouragement (P=.02, d=-.27). However, no significant changes were found in parental mental health scores (P=.47).

Child outcomes also demonstrated significant post-intervention improvements. Emotional reactivity (P=.001, d =.40) and dysphoria (P=.02, d=.27) scores decreased, as measured by the Emotion Dysregulation Inventory. Additionally, enhanced mindful parenting correlated with reductions in child emotional dysregulation (P<.05). Mediation analyses indicated that improvements in parenting practices played a role in linking mindful parenting with better child emotional regulation.

“Offering a child-targeted intervention that can help both children and parents might address some of the intervention implementation barriers (e.g., high caseload, cost) faced in the community,” the study authors concluded.

Study limitations include a sample largely composed of mothers, reducing generalizability to other populations, the virtual format potentially affecting engagement and outcomes, and low baseline mental health concerns making improvements harder to detect.

This research was supported by Kids Brain Health Network, Canadian Institutes of Health Research and York University Research Chair in Autism and Neurodevelopmental Disability Mental Health.

This article originally appeared on Psychiatry Advisor