Reduction in Parenting Stress Following an Early Parent-Mediated Intervention for Autism

Parents of autistic children frequently report elevated parenting stress, particularly stress related to child characteristics, and although parent-mediated interventions have been associated with reduced stress, findings remain mixed. This study examined changes in maternal parenting stress following a six-month early parent-mediated intervention and explored associations with child outcomes, maternal implementation of Naturalistic Developmental Behavioral Intervention (NDBI) strategies, baseline stress, and child age. Forty-five mother–child dyads (mean child age = 15.83 months) participated in a six-month, telehealth-delivered NDBI-based intervention. Maternal stress was assessed before and after treatment using the Parenting Stress Index–Fourth Edition (PSI-4). Wilcoxon signed-rank tests evaluated pre–post changes, and Spearman correlations examined associations with child developmental and autism outcomes, maternal NDBI implementation, baseline stress, and child age. Maternal stress decreased significantly in the PSI-4 Child Domain, particularly on the Acceptability/Distractibility and Reinforces Parent subscales. Greater reductions in Acceptability/Distractibility were associated with greater improvements in autism symptom severity (BOSCC) and developmental functioning (Griffiths-III). Higher baseline stress was associated with greater reductions across PSI-4 domains, whereas no associations emerged with maternal NDBI implementation. Early parent-mediated intervention is associated with reductions in maternal parenting stress, with greater reductions associated with improved child outcomes, supporting parenting stress as a relevant outcome of early autism intervention.