Rethinking parents as therapists for children with ASD: Adding stress to the family system

Abstract

Current recommendations for interventions involving children with Autism Spectrum Disorder (ASD) include parent involvement in implementing therapy. The reasons for this include increased generalization and cost-effectiveness. However, research has not sufficiently addressed the possibility that placing an additional role of a therapist on parents of children with ASD contributes to increased stress. This paper examines some of the main arguments for parents acting as therapists. Specifically, research demonstrates that the role of the parent as therapist is not the only option for increasing generalization and that this form of therapy implementation may not be cost-effective for the family when considering loss of income. Possible implications are discussed, including loss of income, increased time demands, negative effects on relationships between family members, and emotional strain. Future research areas that focus on understanding and addressing the possible negative impacts of parents taking on the role of the therapist are suggested, including an increased focus on interventions in inclusive childcare settings.