Caregiver Mental Health, Adaptive Skills, and Therapeutic Engagement in Children with Autism Spectrum Disorder

Abstract

Caregivers are essential in influencing developmental patterns and treatment outcomes in children with Autism Spectrum Disorder (ASD); nevertheless, caregiver mental health has not been adequately integrated into the autism intervention literature and practice. They were based on the family-centered and transactional development frameworks, and this study analyzed the direct and indirect connections between the mental health of caregivers, therapeutic engagement, and adaptive skills among children with ASD. The cross-sectional type of quantitative design was adopted, which entailed a total of 312 caregivers with a confirmed diagnosis of ASD and children aged between 3 and 12 years. Mental health mental health of the caregiver (stress, anxiety, and depressive syndrome) and therapeutic contact (attendance, in-session participation, and home-based implementation) and adaptive skills of the child (communication, daily skills, and socialization) were measured using standardized measures. The analysis of data was done with descriptive statistics, Pearson correlations, multiple regression analysis, and mediation analysis with bootstrapping. The findings showed that greater amounts of caregiver psychological distress were strongly linked with reduced levels of therapeutic engagement and poor adaptive functioning in all domains. There was a positive relationship between therapeutic engagement and adaptive communication, daily living skills, and socialization. Mediation analyses revealed that therapeutic engagement mediated the relationship between caregiver mental health and child adaptive skills with significant indirect effects found among all adaptive domains. Interestingly, mental health of caregivers remained having a considerable direct effect on adaptive outcomes, which implies a direct and an engagement-mediated influence. These results emphasize the role of caregiver mental health as a severe determinant of intervention participation and development of adaptive skills in the children with ASD. By incorporating mental health assistance of caregivers into the services of autism intervention, it can be expected that therapeutic adherence and maximization of functional outcomes might be achieved.