The Effectiveness of Psychosocial Intervention on Internalized Stigma and Quality of Life in Parents of Children with Autism Spectrum Disorder

Abstract

Background: Improving parental awareness and skills regarding autism spectrum disorder (ASD) can ease caregiving challenges and mitigate stigma-related stress in mothers. Objectives: This study aimed to evaluate the effectiveness of a psychosocial intervention on internalized stigma and quality of life among parents of children with autism. Methods: This quasi-experimental study utilized a pre-test and post-test design with a control group and a two-month follow-up. Targeting parents of children with ASD in Tehran, diagnosed at least four years prior, 30 parents were conveniently sampled and randomly matched by child age into experimental and control groups. The sample size was estimated based on previous studies and statistical power calculations, resulting in 15 participants per group. Parents aged 25 - 50, children aged 3 - 12 with a confirmed autism diagnosis at least four years prior, and willingness to participate were eligible criteria. Participants were excluded if they missed more than two sessions or had recent involvement in similar programs within the past six months. The experimental group underwent 10 psychosocial intervention sessions, while the control group received only necessary rehabilitative services. Assessments were conducted using the World Health Organization Quality of Life Scale (WHOQOL-100) and an Internalized Stigma Questionnaire (ISQ) at three intervals, with data analyzed using SPSS version 25 through analysis of covariance (ANCOVA) and repeated measures ANOVA. Results: Participants averaged 40.3 ± 9.85 years, with no significant age differences between groups, and their children’s mean age was 10.17 years. The ANCOVA revealed significant improvements in internalized stigma and overall quality of life in the experimental group post-intervention, with 27% and 23% of variance explained, respectively. Effect sizes indicated that participation accounted for 23%, 16%, and 43% of the variance in psychological health, social relationships, and environment domains. Repeated measures ANOVA confirmed significant group and time effects on internalized stigma and quality of life, with 61% and 12% of variance attributable to the intervention. Only the social relationships subscale showed significant differences (P < 0.05), explaining 15% of its variance; other subscales showed no significant change. Other subscales, including physical health, psychological health, and environment, did not exhibit significant differences (P > 0.05). Conclusions: The psychosocial intervention program significantly improves stigma perception and quality of life for parents of children with ASD, offering strategies to cope with autism-related challenges effectively.