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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 parenting stress decreased significantly on the Acceptability/Distractibility subscale of the PSI-4 after correction for multiple comparisons. Exploratory analyses yielded nominal associations, unadjusted for multiple comparisons, between greater reductions in Acceptability/Distractibility and greater improvements in autism symptom severity (BOSCC) and developmental functioning (Griffiths-III). Exploratory analyses also revealed that higher baseline stress was associated with greater reductions across PSI-4 domains, whereas no associations emerged with maternal NDBI implementation. These results support parenting stress as a potentially relevant outcome of early autism intervention.
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Costanzo et al. (2026) studied this question.
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