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Resiliency Intervention for Siblings of Children With Autism Spectrum Disorder: A Randomized Pilot Trial

  • Karen A. Kuhlthau
    Correspondence
    Address correspondence to: Karen A. Kuhlthau, PhD, Massachusetts General Hospital, 125 Nashua Street #860, Boston, MA 02114
    Affiliations
    Division of General Academic Pediatrics (KA Kuhlthau, L Fell, and D Iannuzzi), Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Mass

    Department of Pediatrics (KA Kuhlthau), Harvard Medical School, Boston, Mass
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  • Lara Traeger
    Affiliations
    Department of Psychiatry (L Traeger, CM Luberto, GK Perez, BM Goshe, and ER Park), Massachusetts General Hospital/Harvard Medical School, Boston, Mass

    Health Promotion and Resiliency Intervention Research Program (L Traeger, CM Luberto, GK Perez, and ER Park), Massachusetts General Hospital, Departments of Psychiatry & Medicine, Boston, Mass
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  • Christina M. Luberto
    Affiliations
    Department of Psychiatry (L Traeger, CM Luberto, GK Perez, BM Goshe, and ER Park), Massachusetts General Hospital/Harvard Medical School, Boston, Mass

    Health Promotion and Resiliency Intervention Research Program (L Traeger, CM Luberto, GK Perez, and ER Park), Massachusetts General Hospital, Departments of Psychiatry & Medicine, Boston, Mass

    MGH Benson-Henry Institute for Mind-Body Medicine (CM Luberto, GK Perez, BM Goshe, and ER Park), Boston, Mass
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  • Giselle K. Perez
    Affiliations
    Department of Psychiatry (L Traeger, CM Luberto, GK Perez, BM Goshe, and ER Park), Massachusetts General Hospital/Harvard Medical School, Boston, Mass

    MGH Benson-Henry Institute for Mind-Body Medicine (CM Luberto, GK Perez, BM Goshe, and ER Park), Boston, Mass

    Health Promotion and Resiliency Intervention Research Program (L Traeger, CM Luberto, GK Perez, and ER Park), Massachusetts General Hospital, Departments of Psychiatry & Medicine, Boston, Mass
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  • Brett M. Goshe
    Affiliations
    Department of Psychiatry (L Traeger, CM Luberto, GK Perez, BM Goshe, and ER Park), Massachusetts General Hospital/Harvard Medical School, Boston, Mass

    MGH Benson-Henry Institute for Mind-Body Medicine (CM Luberto, GK Perez, BM Goshe, and ER Park), Boston, Mass
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  • Lucy Fell
    Affiliations
    Division of General Academic Pediatrics (KA Kuhlthau, L Fell, and D Iannuzzi), Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Mass
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  • Dorothea Iannuzzi
    Affiliations
    Division of General Academic Pediatrics (KA Kuhlthau, L Fell, and D Iannuzzi), Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Mass
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  • Elyse R. Park
    Affiliations
    Department of Psychiatry (L Traeger, CM Luberto, GK Perez, BM Goshe, and ER Park), Massachusetts General Hospital/Harvard Medical School, Boston, Mass

    Health Promotion and Resiliency Intervention Research Program (L Traeger, CM Luberto, GK Perez, and ER Park), Massachusetts General Hospital, Departments of Psychiatry & Medicine, Boston, Mass

    MGH Benson-Henry Institute for Mind-Body Medicine (CM Luberto, GK Perez, BM Goshe, and ER Park), Boston, Mass
    Search for articles by this author
Published:November 29, 2022DOI:https://doi.org/10.1016/j.acap.2022.11.011

      Abstract

      Background /Objectives

      Neurotypical siblings (NT siblings) of children with autism spectrum disorder (ASD) are at elevated risk for emotional distress and adjustment problems. Resiliency is the ability to cope and adapt with ongoing stressors. We conducted a randomized waitlist-controlled pilot trial to examine the feasibility, acceptability, and preliminary efficacy of an adapted virtual mind-body resiliency group intervention for teen NT siblings of children with ASD.

      Methods

      We modified the Stress Management and Resiliency Training-Relaxation Response Resiliency Program for NT siblings of children with ASD (SibChat). We randomly assigned teens (aged 14–17) to immediate intervention (IG) versus waitlist control (WLC). The intervention included eight 60-minute weekly video conference group sessions. We assessed feasibility (enrollment, attendance, and retention) and acceptability (post treatment survey and weekly relaxation response practice). We explored group differences in pre-post change scores for 1) stress coping (Measure of Current Status-A) and 2) resiliency (Current Experiences Scale) using independent samples t tests and effect size calculations.

      Results

      We enrolled 83% of screened eligible teens. A total of 90% IG and 75% WLC participants attended at least 6/8 sessions. Among IG participants who completed the post treatment survey, 79% reported practicing relaxation response exercises at least “a few times a week”. Comparing change in baseline to time 1, the IG showed better relative changes than the WLC group in stress coping (d = 0.60) and resiliency (d = 0.24).

      Conclusions

      Our pilot trial showed promising feasibility, acceptability, and preliminary efficacy of SibChat on at least one of the 2 primary outcomes supporting further testing of the SibChat intervention.

      Clinical Trial Registration

      US National Library of Medicine. Registration number: NCT04369417. https://clinicaltrials.gov/ct2/show/NCT04369417.

      Keywords

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      References

        • Watson L
        • Hanna P
        • Jones CJ.
        A systematic review of the experience of being a sibling of a child with an autism spectrum disorder.
        Clin Child Psychol Psychiatry. 2021; 26: 734-749https://doi.org/10.1177/13591045211007921
        • Griffith GM
        • Hastings RP
        • Petalas MA.
        Fathers’ and mothers’ ratings of behavioral and emotional problems in siblings of children with autism spectrum disorder.
        J Autism Dev Disord. 2014; 44: 1230-1235https://doi.org/10.1007/s10803-013-1969-6
        • Lovell B
        • Wetherell MA.
        The psychophysiological impact of childhood autism spectrum disorder on siblings.
        Res Dev Disabil. 2016; 49-50: 226-234https://doi.org/10.1016/j.ridd.2015.11.023
        • Meyer KA
        • Ingersoll B
        • Hambrick DZ.
        Factors influencing adjustment in siblings of children with autism spectrum disorders.
        Res Autism Spectr Disord. 2011; 5: 1413-1420https://doi.org/10.1016/j.rasd.2011.01.027
        • Shivers CM
        • McGregor C
        • Hough A.
        Self-reported stress among adolescent siblings of individuals with autism spectrum disorder and Down syndrome.
        Autism. 2019; 23: 112-122https://doi.org/10.1177/1362361317722432
        • Shivers CM
        • Jackson JB
        • McGregor CM.
        Functioning among typically developing siblings of individuals with autism spectrum disorder: a meta-analysis.
        Clin Child Fam Psychol Rev. 2019; 22: 172-196https://doi.org/10.1007/s10567-018-0269-2
        • Walton K
        • Ingersoll B.
        Psychosocial adjustment and sibling relationships in siblings of children with autism spectrum disorder: risk and protective factors.
        J Autism Dev Disord. 2015; 45: 2764-2778https://doi.org/10.1007/s10803-015-2440-7
        • Macks RJ
        • Reeve RE.
        The adjustment of non-disabled siblings of children with autism.
        J Autism Dev Disord. 2007; 37: 1060-1067https://doi.org/10.1007/s10803-006-0249-0
      1. How to help children and teens manage their stress. American Psychological Association. Updated October 19, 2022. Available at: https://www.apa.org/topics/children/stress. Accessed December 28, 2022.

        • Yılmaz B
        • Azak M
        • Şahin N.
        Mental health of parents of children with autism spectrum disorder during COVID-19 pandemic: a systematic review.
        World J Psychiatry. 2021; 11: 388-402https://doi.org/10.5498/wjp.v11.i7.388
        • Tsao LL
        • Davenport R
        • Schmiege C.
        Supporting siblings of children with autism spectrum disorders.
        Early Child Educ J. 2012; 40: 47-54https://doi.org/10.1007/s10643-011-0488-3
        • Brouzos A
        • Vassilopoulos SP
        • Tassi C.
        A psychoeducational group intervention for siblings of children with autism spectrum disorder.
        J Spec Group Work. 2017; 42: 274-298https://doi.org/10.1080/01933922.2017.1350230
        • Cooke J
        • Semmens C.
        The development and evaluation of a support group for siblings of children on the autism spectrum.
        Good Autism Pract GAP. 2010; 11: 23-30
        • Kryzak LA
        • Cengher M
        • Feeley KM
        • et al.
        A community support program for children with autism and their typically developing siblings: Initial investigation.
        J Intellect Disabil JOID. 2015; 19: 159-177https://doi.org/10.1177/1744629514564450
        • Smith T
        • Perry A.
        A sibling support group for brothers and sisters of children with autism.
        J Dev Disabil. 2005; 11: 77-88
        • Jones EA
        • Fiani T
        • Stewart JL
        • et al.
        Randomized controlled trial of a sibling support group: mental health outcomes for siblings of children with autism.
        Autism. 2020; 24: 1468-1481https://doi.org/10.1177/1362361320908979
        • Park ER
        • Traeger L
        • Vranceanu AM
        • et al.
        The development of a patient-centered program based on the relaxation response: the relaxation response resiliency program (3RP).
        Psychosomatics. 2013; 54: 165-174https://doi.org/10.1016/j.psym.2012.09.001
        • Park ER
        • Luberto CM
        • Chad-Friedman E
        • et al.
        A comprehensive resiliency framework: theoretical model, treatment, and evaluation.
        Glob Adv Health Med. 2021; 1021649561211000304https://doi.org/10.1177/21649561211000306
        • Iannuzzi D
        • Fell L
        • Luberto C
        • et al.
        Challenges and growth: lived experience of adolescents and young adults (AYA) with a sibling with ASD.
        J Autism Dev Disord. June 13, 2021; (Published online)https://doi.org/10.1007/s10803-021-05135-0
        • Kuhlthau KA
        • Luberto CM
        • Traeger L
        • et al.
        A virtual resiliency intervention for parents of children with autism: a randomized pilot trial.
        J Autism Dev Disord. 2020; 50: 2513-2526https://doi.org/10.1007/s10803-019-03976-4
        • Mizrach H
        • Goshe B
        • Park ER
        • et al.
        Bounce back study protocol: randomized waitlist-control trial of a web-based stress-management and resiliency program for adolescent and young adult cancer survivors.
        JMIR- Res Protoc. 2022; 11e34033https://doi.org/10.2196/34033
      2. Carver CS. MOCS (Measure of Current Status). Published 2006. Available at: http://local.psy.miami.edu/faculty/ccarver/sclMOCS.phtml. Accessed January 09, 2023.

        • Berle D
        • Starcevic V
        • Moses K
        • et al.
        Preliminary validation of an ultra-brief version of the Penn State Worry Questionnaire.
        Clin Psychol Psychother. 2011; 18: 339-346https://doi.org/10.1002/cpp.724
        • Meyer TJ
        • Miller ML
        • Metzger RL
        • Borkovec TD.
        Development and validation of the Penn State Worry Questionnaire.
        Behav Res Ther. 1990; 28https://doi.org/10.1016/0005-7967(90)90135-6
      3. NCCN. NCCN clinical practice guidelines in OncologyTM distress management V1.; 2021: Available at: http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf/. Accessed January 09, 2023.

        • Quinn H
        • Thissen D
        • Liu Y
        • et al.
        Using item response theory to enrich and expand the PROMIS® pediatric self report banks.
        Health Qual Life Outcomes. 2014; 12: 160https://doi.org/10.1186/s12955-014-0160-x
        • Forrest CB
        • Meltzer LJ
        • Marcus CL
        • et al.
        Development and validation of the PROMIS pediatric sleep disturbance and sleep-related impairment item banks.
        Sleep. 2018; 41https://doi.org/10.1093/sleep/zsy054
        • Laurent J
        • Catanzaro SJ
        • Joiner Jr., TE
        • et al.
        A measure of positive and negative affect for children: scale development and preliminary validation.
        Psychol Assess. 1999; 11: 326-338https://doi.org/10.1037/1040-3590.11.3.326
        • Kuby AK
        • McLean N
        • Allen K.
        Validation of the Child and Adolescent Mindfulness Measure (CAMM) with Non-Clinical Adolescents.
        Mindfulness. 2015; 6: 1448-1455https://doi.org/10.1007/s12671-015-0418-3
        • Park ER
        • Perez GK
        • Millstein RA
        • et al.
        A virtual resiliency intervention promoting resiliency for parents of children with learning and attentional disabilities: a randomized pilot trial.
        Matern Child Health J. 2020; 24: 39-53https://doi.org/10.1007/s10995-019-02815-3
        • Wartella E
        • Rideout V
        • Montague H
        • et al.
        Health and technology: a national survey.
        Media Commun. 2016; 4: 13-23https://doi.org/10.17645/mac.v4i3.515
        • Killgore WDS
        • Taylor EC
        • Cloonan SA
        • Dailey NS.
        Psychological resilience during the COVID-19 lockdown.
        Psychiatry Res. 2020; 291113216https://doi.org/10.1016/j.psychres.2020.113216
        • Plante W.
        Helping siblings of children with behavioral health disorders weather the COVID-19 storm.
        Brown Univ Child Adolesc Behav Lett. 2020; 36: 1-6https://doi.org/10.1002/cbl.30500
        • Klingbeil DA
        • Renshaw TL
        • Willenbrink JB
        • et al.
        Mindfulness-based interventions with youth: a comprehensive meta-analysis of group-design studies.
        J Sch Psychol. 2017; 63: 77-103https://doi.org/10.1016/j.jsp.2017.03.006
        • Zoogman S
        • Goldberg SB
        • Hoyt WT
        • Miller L.
        Mindfulness interventions with youth: a meta-analysis.
        Mindfulness. 2015; 6: 290-302https://doi.org/10.1007/s12671-013-0260-4