Outcomes of an Executive Function Coaching and Training Program for Parents of Children with ASD

• In Event: Poster Session 10
  In Poster Session: PS 10 Topic - Developmental Disabilities

Abstract

Background: Impairments in executive function (EF), defined as the higher-order processes necessary for regulating and controlling behavior, are common among children with autism spectrum disorder (ASD; Demetriou et al., 2018; Pellicano, 2012). Executive function is found to be associated with social competence, adaptive behavior, and academic success, while executive dysfunction is found to be associated with parenting stress and the presence of psychiatric comorbidities (Hutchison et al., 2016; Lawson et al., 2015; Pellicano, 2012). Interventions targeting executive function in children with ASD hold promise for improving both child and family outcomes. The aim of this study was to evaluate changes in parenting stress and child executive function following a training and coaching program for parents.

Method: Sixty-seven parents of children aged 5-13 years with ASD completed an online executive functioning course for parents, e-Unstuck and On Target, over nine weeks (Kenworthy et al., 2014, 2018). Parents also attended weekly telehealth coaching sessions in small groups led by masters- and doctoral-level clinicians. The Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF; Abidin, 2012), Behavior Rating Inventory of Executive Function – Second Edition (BRIEF-2; Gioia et al., 2015), and an executive function knowledge test were completed pre- and post-intervention. Parents also reported the number of modules and worksheets completed, number of attempted strategies, overall effort throughout the program, and satisfaction.

Results: Dependent samples t-tests revealed significant changes in PSI-4-SF Parental Distress (Mpre = 57.67, SD = 8.71; Mpost = 55.53, SD = 7.27), PSI-4-SF Total Stress (Mpre = 62.52, SD = 8.19; Mpost = 61.02, SD = 7.89), BRIEF-2 Shift (Mpre = 79.33, SD = 8.38; Mpost = 76.21, SD = 8.52), BRIEF-2 Emotional Control (Mpre = 70.69, SD = 10.41; Mpost = 67.90, SD = 11.13), BRIEF-2 Emotion Regulation Index (Mpre = 76.74, SD = 9.21; Mpost = 73.90, SD = 10.58), BRIEF-2 Global Executive Composite (Mpre = 77.52, SD = 1.13; Mpost = 73.69, SD = 1.14), and executive function knowledge (Mpre = 86.82, SD = 1.62; Mpost = 95.09, SD = 2.54; all p’s < .05). Difference scores for significant variables were calculated. Spearman rank-order correlation analyses showed significant correlations between modules completed and BRIEF-2 Global Executive Composite change (rs = .40), worksheets completed and PSI-4-SF Parental Distress change (rs = .33), and worksheets completed and PSI-4-SF Total Stress change (rs = .32; all p’s < .05). Over 95% of parents reported that they learned something new, were more informed about executive function, thought they could more effectively deal with their child’s executive function difficulties, believed the program was worth the time and effort, and reported overall program satisfaction.

Conclusions: The parent training and coaching program was effective in improving children’s ability to regulate emotional responses and adjust to changes in environment, people, plans, or demands per parent report. Parents also reported improvements in knowledge of executive function, reductions in parenting stress, and high levels of satisfaction. Moreover, active engagement with the program (e.g., completing more worksheets and modules) was associated with better outcomes for families.

Authors

• Emma Skye Wilkinson, State University of New York at Albany (SUNY Albany)
  Presenting Author

• Anna Milgramm, State University of New York at Albany (SUNY Albany)
  Non-Presenting Author

• Melissa Lynn Rinaldi, State University of New York at Albany (SUNY Albany)
  Non-Presenting Author

• Kristin Knapp-Ines, SUNY Albany
  Non-Presenting Author

• Kristin Christodulu, State University of New York at Albany
  Non-Presenting Author