A Randomized Controlled Trial of Telehealth Mindful Parenting Training on Executive Function in Autistic Children and Their Parents

Abstract

This randomized controlled trial study explored the effect of telehealth mindful parenting group intervention on executive function in autistic children and their parents. Participants included 83 caregivers (29–54 years) of autistic children (5–18 years) in the United States who were randomized into either the immediate (n = 40) or waitlist-control group (n = 43). Of the participants randomized, 55 caregivers (immediate = 33; waitlist = 22) received the allocated intervention and were included in the primary analysis. Caregivers in the sample (mean age of 42.97 years) were mostly white (73%), married (76%), female (80%), biological mothers (67%), from Washington state (62%), and in opposite-sex relationships (62%). Children in the sample were predominantly white (71%) males (73%) with a mean age of 10.18 years. Wilcoxon rank sum test were conducted to compare executive function and mental health outcomes between immediate and waitlist-control groups. Wilcoxon signed rank tests were conducted on pairwise comparisons between baseline and post-treatment as well as baseline and follow-up parent and child executive function scores. Results showed that the immediate group demonstrated higher parent-reported child executive function change scores (W = 2178, p < .001, d = .46) but no group differences in self-reported parent executive function change scores (W = 1628, p = .375, d = 0.06) at post-treatment. Secondary analyses showed that parent and child executive function improved at post-treatment and 2-month follow up, compared to baseline, across the pooled sample. Further, parents in the immediate treatment group showed greater improvement in emotion regulation, mindful parenting, general mindfulness, compassion, self-compassion and also greater decrease in depression, anxiety, parenting stress, and general stress compared to the waitlist group at post-treatment. No group difference on overall life satisfaction was found. This was the first investigation to explore the impact of telehealth mindful parenting group training on executive function in autistic children and their parents. It offers evidence for the benefits of mindful parenting intervention delivered virtually for parents of children with autism on child executive function and parental psychological health. Future research should focus on exploring the underlying mechanisms by which mindful parenting training influences child executive function.

Alternate abstract:

这项随机对照试验探讨了远程医疗正念教养小组干预对自闭症儿童及其父母执行功能的影响。参与者包括在美国83名自闭症儿童（5–18 岁）的照顾者（29–54 岁），他们被随机分配到立即干预组（n = 40）或 候补对照组（n = 43）。在随机分配的参与者中，55 名照顾者（立即干预 组 = 33 名；候补对照组 = 22 名）依据试验方案，并纳入主要分析里。样本中的照顾者（平均年龄42.97岁）大多是白人（73%）、已婚（76%）、女性（80%），亲生母亲（67%）来自华盛顿州（62%），及异性伴侣（ 62%）。样本中的儿童大多数是白人 (71%) 男性 (73%)，平均年龄为 10.18 岁。 本试验使用 Wilcoxon秩和检验来比较干预组和候补对照组之间的执行功能和心理健康结果。对成对比较则使用 Wilcoxon符号秩来检验基线和治疗后以及基线和 随访父母 和儿童执行功能分数的比较 。结果显示，立即干预组表现出更高的父母报告的儿童执行功能变化分数（W = 2178，p <.001，d = .46），但自我报告的父母执行功能变化分数无组间差异 (W = 1628, p = .375, d = 0.06) 。次级分析显示，与基线相比，在合并样本中，父母和孩子的执行功能在治疗后和 2 个月的随访中有所改善。此外，治疗后，与候补对照组相比立即干预组的父母在情绪调节、正念养育、一般正念、同情心、自我同情心表现出更大的改善，以及抑郁、焦虑、育儿压力和一般压力有更大程度的降低。未发现总体生活满意度存在组间差异。这是第一项探讨远程医疗正念教养小组培训对自闭症儿童及其父母执行功能影响的调查。它提供以视讯方式为自闭症儿童的父母提供正念教养干预对儿童执行功能和父母心理健康的好处的证据。未来的研究应侧重于探索正念育儿训练影响儿童执行功能的潜在机制。