Impact of IY® Autism Program on Parent's Feelings of Self-efficacy

Incredible Years® Autism Parent Group Leader Victoria Muschietti-Piana recently conducted research into the impact of the IY Autism program on parent perceptions of self-efficacy as part of her graduate studies at Middlesex in London. Her research is a valuable addition to our knowledge about how the program works for families. She has shared a summary of her findings with us.

CHANGES IN PARENTAL SELF-EFFICACY FOLLOWING “AUTISM SPECTRUM DISORDER AND LANGUAGE DELAY INCREDIBLE YEARS” PARENTING PROGRAMME

By Victoria Muschietti-Piana

As a Clinical Psychologist training and working in Argentina and the UK for the past 18 years, I am interested in understanding how local authorities can support parents to develop enhanced self-efficacy.  I sought, in particular, to marry my knowledge of Neurodevelopmental disorders to this topic as part of my Masters in Autism and related conditions. The following summary focuses on research conducted in Merton, a Borough in London, during 2019.  The full dissertation can be accessed here.

I trained with Peter Loft in the UK in Incredible Years® Autism Spectrum and Language Delays programme and have spent the past four years delivering early help interventions using Positive Intervention Parenting Training (PIPT). I became interested in applying these techniques to Neurodevelopmental children and their families to observe impacts on self-efficacy. Based on the outcomes of my research I am now encouraging service provision expansion across London to provide better outcomes. 

The Incredible Years® Autism and Language Delays programme (IY® ASLD) was created to promote parenting competence and child development by offering strategies to address social skills, communication and language, emotion regulation, and school readiness in children. The IY® ASLD programme constitutes an adaptation of the IY® programme in 2015 to be used with parents of children on the Autism Spectrum and for those who had language delay difficulties (Dababnah et al., 2019). The programme is specifically designed for parents of children between the ages of 3 and 6. The programme is divided into 8 topics: (1) child directed narrated play; (2) pre academic and persistent coaching; (3) social coaching; (4) emotional coaching; (5) developing imagination through pretend play; (6) children self-regulation skills; (7) using praise and rewards to motivate children; and (8) effective limit setting and behaviour management (Hutchings et al., 2016). The programme uses a collaborative approach, encouraging parents to learn from each other. The intervention is delivered by a trained practitioner who also receives supervision from an accredited supervisor in IY®ASLD (Webster-Stratton, 2015).

Why was I interested in doing this study?

This research assessed if the IY® ASLD programme improves parental self-efficacy. Though parental self-efficacy has been used as an outcome measure in some empirical studies of intervention programmes, there are no studies – neither in the IY® ASLD pilot studies, nor in feasibility studies – where specific measures to identify changes in parenting self-efficacy have been used. would therefore be highly beneficial to test the impact on specific variables Pre and Post parenting interventions.

Methods: This study was part of a natural experiment in one group of participants of the IY® ASLD programme and utilised data from Pre and Post questionnaire completion. This questionnaire consisted of a Tool to measure Parenting Self-Efficacy, the TOPSE scale (Kendall and Bloomfield, 2005). This measure is a 48-item tool with 8 scales. Each scale has 6 statements and represents a different dimension of parenting or ‘domains’ such as: emotion and affection, play and enjoyment, empathy and understanding, control, discipline and boundaries, pressures, self-acceptance, learning and knowledge (Fig. 1). Qualitative information about the participant’s feedback was also obtained from the TOPSE scale comments section (Fig. 2).

Participants were recruited from a Children’s Centre in London where the intervention was being delivered by trained staff who had previous experience delivering other Incredible Years® programmes. Eleven families took part in the study (5 White British, 3 Indian, 1 Pakistani, 1 Black African and 1 white other). The ages of the children, whose parents received the intervention, ranged from 2.5 to 4 years old.

Results: An overall significant improvement in parental self-efficacy Post IY® ASLD parenting programme (Fig. 1a) was identified. Results showed significant improvement in the ‘play and enjoyment’ and ‘learning and knowledge’ domains (Fig. 1b). This can be attributed to the fact that parents have found new ways of playing and enjoying time with their children. Furthermore, the study has highlighted that the programme has taught new and innovative ways of playing with a child, and aiming to increase eye contact, which has shown an upturn in the learning domain. Feedback after the course was entirely positive, and indicative of the benefits of the IY® ASLD programme for improving parenting skills.

Fig. 1. Mean scores for total TOPSE scale (a) and for all domains (b) at Pre (white columns) and Post (green columns) IY® ASLD parenting programme. Columns indicate mean values and vertical bars indicate standard error of the mean. *= indicate significant differences between ‘pre’ and ‘post’ parental self-efficacy programme within each domain’s mean scoring value (paired-sample t test p < .05).

At the end of the programme, there were complementary comments from the participants and they were grouped in six themes based on the main key words that were identified. The frequency of each theme was expressed in percentage (as shown in parenthesis in each Theme in Fig. 2) and calculated from the ratio of the number of participants commenting on each theme and the number of participants that completed the comments section at the end of the course.

‘Building confidence as a parent (Theme 1)’ was the most frequent theme amongst the participants’ comments, as 90% agreed that the course was very helpful to build more confidence as a parent of a child with ASD. This theme was the most frequent aspect that was associated with the majority of the other themes (Fig. 2). A sense of confidence resulted from ‘networking’ (Theme 3), that can be inferred from comments like “sharing ideas with the parents…” or “listening to other parents made me feel confident”. Confidence in self-parenting can be found as a result of the ability to develop new strategies (Theme 2); and/or having tools to calm/regulate the child (Theme 5); and/or being involved in a contention group providing support (Theme 4). During the programme parents learnt how to formulate positive statements about themselves and of each other. This was partly supported by programme facilitators whose role is to encourage parents to set up tangible rewards for their achieved weekly goals. This approach promotes a sense of parenting competence. Parents are encouraged to develop a positive self-talk, which will have an impact on their parental self-efficacy (Webster-Stratton, 2015).

Fig. 2. Thematic map summarising the six main themes identified from participant’s feedback at Post IY® ASLD programme.

Conclusion: The study demonstrated that the IY® ASLD is a cost-effective programme that can be implemented to support families with children with social communication difficulties and/or language delay. Parents with children with neurodevelopmental disorders benefitted from being part of a group and sharing their experiences together. Parents practiced new skills such as: social coaching, regulating their child’s emotions and encouraging language development through role-plays during sessions. In the present study, all these new strategies may have contributed to the overall increase in parental self-efficacy.

Despite the strong evidence that early intervention has positive outcomes in the relationship between parent and child with ASD, limited support is provided in the UK to parents of children with neurodevelopmental disorders, particularly those with autism. In this context, making use of cost-effective parenting programmes like the IY® ASLD becomes vital to bridge that gap.

Relevance to clinical practice: Delivering the IY® ASLD programme to families whose children have been diagnosed with a neurodevelopmental disorder, or are still waiting to be assessed, will be of benefit to clinical practice at Children Centres or at other early intervention services.

Victoria works as a Clinical Psychologist in London and has diplomas in Cognitive Behaviour Therapy and Systemic Therapy.  She has a Certificate in Counselling Children using Art.  Victoria currently conducts autism assessments and is trained in ADOS and ADI-R.  

Cheers to Victoria! Read Victoria’s Dissertation Here!

Incredible Years® Program training is now online! If you would like to receive training to deliver the Incredible Years® Autism program, or any of our other programs, please visit www.incredibleyears.com/workshop-info/training-workshop-schedule/