Heart-Mind-Behavior Parent Training: Randomized controlled trial for Chinese parents of young children with ASD

Evidence-based ASD interventions in developing countries are usually scarce and expensive for average families. Interventions adopted from the West often lack cultural adaptations and local effectiveness evaluations. In Mainland China, predominant ASD interventions are based on Applied Behavior Analysis (ABA), first developed in the mid-20th century. In this study, a relationship-based parent-mediated intervention, named the Heart-Mind-Behavior Training Program, was developed and evaluated for its effectiveness in Chinese parents of children with ASD. The program included eight weekly 2-h sessions targeting key areas in relationship-based ASD intervention, emphasizing what Chinese parents need help most (parental sensitivity, mind-mindedness, and using symbolic-pretend play to coach children's socio-emotional skills).

This study comprised two phases. The pilot study involved 11 parents of ASD at-risk children participating in the program. The main study utilized a randomized waitlist-control design to evaluate the program, with 81 parents of 3- to 6-year-olds with ASD, randomized to either intervention or waitlist-control conditions.

The pilot study indicated participant satisfaction, program feasibility, and preliminary efficacy. In the main study, significant intervention effects were found for parental self-efficacy, mind-mindedness, and autonomy support, as indicated by significant group × time interactions. At the 4-month follow-up, child's ASD symptomatology, parenting stress, parent-child relationship, and parental sensitivity significantly improved in the intervention group compared to baseline or immediate posttest.

This study demonstrated the benefits of this parent-training program, highlighting its potential for culturally sensitive and effective interventions for Chinese families of young children with ASD.