School-based executive function interventions reduce caregiver strain

Children with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) possess challenges with executive functioning (EF) and behavior problems. Their caregivers report higher levels of stress compared to those of neurotypical children which may relate to these problems. Few studies have examined both child and caregiver outcomes in child-focused interventions. This study reports on the effects of two school-based interventions, which improved child EF functioning, on caregiver stress, competency and self-efficacy and their relation to child outcomes. Participants included 102 parents of 3rd-5th graders, diagnosed with ASD or ADHD, participating in EF-focused interventions, which involved weekly, small EF pull-out groups for children and, for parents, short handouts covering implemention strategies, a parent workbook and up to 4 parent trainings. Significant decreases in objective and subjective strain from pre- to post-treatment corresponded with increases in caregiver rated program satisfaction and helpfulness and of comfort in the ability to help their child. No significant changes were observed in parent competency or self-efficacy. Parent-report of behavioral/emotional problems, but not observation or teacher report, correlated with increased ratings of caregiver strain at baseline and greater reductions over the course of treatment. The results underline the potential for child-focused interventions in schools to positively impact caregiver outcomes.