Association of Working Alliance and Parenting Stress for Mothers of Toddlers At-Risk for Autism Spectrum Disorder

Introduction: Parents of children with autism spectrum disorder (ASD)consistently report elevated levels of parenting stress. The complexities associated with raising a child with ASD put parents at greater risk, highlighting the importance of understanding potential stressors and protective factors that impact parental wellbeing. As the prevalence of ASD continues to increase, children are being screened and identified at earlier ages. Still, little is understood about parents of children at-risk and the factors associated with parenting stress within this population. The purpose of this study was to examine stress profiles for parents of very young children at-risk, and to examine the working relationship or alliance between parents and early interventionists providing a research based intervention program.Methods: This study utilized a working alliance framework to examine the association of alliance on lowering parental stress levels over the course of a 12-week parent mediated early intervention project. 66 toddlers at risk for autism were randomized into 12 sessions of a parent-mediated intervention group or 4 sessions of a parent education group. 45 of the 66 participants were included in the current sample. Parenting stress was measured at twotime points pre and post treatment, and working alliance was measured post treatment.Results: Findings suggest that the caregivers in this study who participated in a parent-mediated intervention for their toddler at-risk reported on average clinical levels of parenting stress, as has been reported by parents of older children with ASD. Findings also showed that caregivers who participated in a parent-mediated treatment condition demonstrated higher alliance than the monitoring group. Alliance was marginally associated with lower parenting stress at the end of treatment.Conclusion: Future studies should examine alliance and parenting stress in larger samples as alliance could be an important factor in lowering parenting stress for families of at risk toddlers who are engaged in early intervention