Effects of remote support courses on parental mental health and child development in autism: A randomized controlled trial

Table 1 Comparisons of the demographic characteristics between the two groups at baseline, n (%)/mean ± SD

Variable	Experimental group (n = 71)	Control group (n = 69)	χ2/t/Z	P value
Children’s gender
Boy	57 (80.28)	58 (84.06)	10.340	0.560
Girl	14 (19.72)	11 (15.94)
Children’s age in months	33.66 ± 8.60	32.83 ± 8.35	2-0.583	0.561
Parents
Father	15 (21.13)	17 (24.64)	10.245	0.621
Mother	56 (78.87)	52 (75.36)
Parents’ age in years	32.41 ± 4.41	32.86 ± 4.26	20.609	0.544
Educational level
Senior high school or below	18 (25.35)	23 (33.33)	3-0.795	0.427
College or undergraduate	50 (70.42)	42 (60.87)
Postgraduate or above	3 (4.23)	4 (5.80)
Occupation
Employed	61 (85.92)	54 (78.26)	11.398	0.237
Unemployed	10 (14.08)	15 (21.74)
Average annual household income in RMB
≤ 50000	13 (18.31)	20 (28.99)	3-1.388	0.165
50000-100000	21 (29.58)	20 (28.99)
100000-200000	26 (36.62)	19 (27.54)
> 200000	11 (15.49)	10 (14.49)
Residence
Urban	37 (52.11)	39 (56.52)	10.274	0.601
Rural	34 (47.89)	30 (43.48)
Family structure
Nuclear family	25 (35.21)	24 (34.78)	11.697	0.428
Immediate family 1	38 (53.52)	32 (46.38)
Immediate family 2	8 (11.27)	13 (18.84)
Number of children	1.35 ± 0.56	1.54 ± 0.68	21.752	0.082
CARS	35.92 ± 5.08	36.42 ± 5.22	20.580	0.563
GDS
Adaptability	64.11 ± 18.22	64.62 ± 20.23	20.157	0.875
Gross motor skills	71.92 ± 14.95	74.99 ± 16.72	21.146	0.254
Fine motor skills	67.17 ± 18.95	70.12 ± 17.79	20.948	0.345
Language	44.32 ± 19.19	40.84 ± 16.66	2-1.145	0.254
Personal-social behavior	52.92 ± 13.76	51.68 ± 15.30	2-0.502	0.616

¹χ² test.

²t test.

³Mann-Whitney U test.

Nuclear family: Parents and minor children live together; Immediate family 1: Nuclear family and grandparents who can offer some help; Immediate family 2: Nuclear family and grandparents who cannot offer any help; CARS: Childhood autism rating scale; GDS: Gesell developmental schedules.

Table 2 Comparisons of scores on the parenting stress index-short form between two groups before and after the intervention, mean ± SD

Variable	Experimental group (n = 71)	Control group (n = 69)	t	P value
PD
Pre-intervention	33.30 ± 9.16	33.48 ± 9.16	0.118	0.906
Post-intervention	28.03 ± 9.64	31.84 ± 8.57	0.267	0.015a
t/P value	7.225/< 0.001b	2.755/< 0.001b
PCDI
Pre-intervention	28.51 ± 7.95	28.41 ± 6.60	-0.082	0.935
Post-intervention	24.28 ± 8.00	27.20 ± 6.79	0.075	0.021a
t/P value	6.319/< 0.001b	2.483/0.015a
DC
Pre-intervention	32.94 ± 7.28	35.10 ± 7.02	1.785	0.076
Post-intervention	28.79 ± 8.29	33.06 ± 7.63	0.364	0.002b
t/P value	6.157/< 0.001b	4.613/< 0.001b
Total score
Pre-intervention	94.75 ± 20.95	96.99 ± 19.53	0.654	0.514
Post-intervention	81.10 ± 19.76	92.10 ± 19.26	0.476	0.001b
t/P value	9.540/< 0.001b	4.663/< 0.001b

^aP < 0.05.

^bP < 0.01.

PD: Parenting distress; PCDI: Parent-child dysfunctional interaction; DC: Difficult child.

Table 3 Comparisons between two groups on the parenting sense of competence scale before and after the intervention, mean ± SD

Variable	Experimental group (n = 71)	Control group (n = 69)	t	P value
Efficacy
Pre-intervention	26.66 ± 5.88	27.54 ± 5.20	0.931	0.353
Post-intervention	30.65 ± 6.49	28.45 ± 5.64	-2.137	0.034a
t/P value	8.334/< 0.001b	1.907/< 0.001b
Satisfaction
Pre-intervention	32.72 ± 8.17	33.94 ± 6.89	0.957	0.340
Post-intervention	38.18 ± 7.06	35.46 ± 7.01	-2.286	0.024a
t/P value	6.414/< 0.001b	2.508/0.015a
Total score
Pre-intervention	59.38 ± 11.59	61.48 ± 9.94	1.148	-2.634
Post-intervention	68.83 ± 11.23	63.91 ± 10.86	0.253	0.009b
t/P value	8.092/< 0.001b	2.807/0.005b

^aP < 0.05.

^bP< 0.01.

Table 4 Comparisons of scores on the generalized anxiety disorder-7 and patient health questionnaire-9 between two groups before and after the interventions, mean ± SD

Variable	Experimental group (n = 71)	Control group (n = 69)	t	P value
GAD-7
Pre-intervention	5.85 ± 4.67	4.91 ± 4.63	-1.186	0.238
Post-intervention	2.89 ± 3.19	3.67 ± 3.92	0.124	0.199
t/P value	7.323/< 0.001b	3.599/0.001b
PHQ-9
Pre-intervention	5.48 ± 4.86	5.04 ± 4.77	-0.535	0.594
Post-intervention	2.77 ± 3.00	3.48 ± 4.27	0.090	0.260
t/P value	6.590/< 0.001b	4.725/< 0.001b

^bP < 0.01.

GAD-7: Generalized anxiety disorder-7; PHQ-9: Patient health questionnaire-9.

Table 5 Comparisons of the training duration between two groups after the intervention, mean ± SD

Variable	Experimental group (n = 71)	Control group (n = 69)	t	P value
Training duration in hours
Pre-intervention	0	0
Post-intervention	12.78 ± 3.16	11.57 ± 3.15	-2.266	0.025a

^aP < 0.05.

Table 6 Comparisons of scores on the childhood autism rating scale and the Gesell developmental schedules between two groups before the intervention and at the follow-up, mean ± SD

Variable		Experimental group (n = 24)	Control group (n = 19)	t	P value
GDS
Adaptability	Pre-intervention	70.67 ± 17.75	73.74 ± 16.19	0.585	0.562
	Post-intervention	75.88 ± 20.14	78.74 ± 14.79	0.518	0.607
	t/P value	-1.403/0.174	-1.485/0.155
Gross motor skills	Pre-intervention	79.88 ± 16.00	80.11 ± 15.61	0.047	0.962
	Post-intervention	82.17 ± 16.45	79.21 ± 13.84	-0.627	0.534
	t/P value	-0.792/0.436	0.516/0.612
Fine motor skills	Pre-intervention	77.79 ± 16.14	75.21 ± 14.97	-0.537	0.594
	Post-intervention	83.17 ± 21.60	78.16 ± 14.26	-0.871	0.389
	t/P value	-1.411/0.172	-0.923/0.368
Language	Pre-intervention	51.25 ± 21.27	46.00 ± 14.89	-0.950	0.348
	Post-intervention	59.33 ± 23.38	60.16 ± 18.15	0.126	0.900
	t/P value	-1.745/0.094	-4.453/< 0.001b
Personal-social behavior	Pre-intervention	61.25 ± 14.189	57.84 ± 12.668	-0.819	0.417
	Post-intervention	68.88 ± 19.447	63.00 ± 13.772	0.146	0.272
	t/P value	-1.758/0.092	-1.665/0.113
CARS	Pre-intervention	34.17 ± 5.895	35.16 ± 6.930	0.507	0.615
	Post-intervention	30.54 ± 7.437	33.05 ± 6.980	1.129	0.265
	t/P value	2.476/0.021a	1.284/0.216

^aP < 0.05.

^bP < 0.01.

CARS: Childhood autism rating scale; GDS: Gesell developmental schedules