Abstract
Improving the family environment, service access, and behavioral adjustment of children
with Autism Spectrum Disorder (ASD) has high relevance both for the children and their families
as well as for health care and service payors. Family environment is a critical influence on ASD
children’s adjustment: Poor parent adjustment increases behavior problems in ASD children,
reduces parents’ capacity to access and adhere to critical services, and dampens or eliminates
the benefits of early intervention. However, due to the stressors of navigating ASD-related and
medical services, as well as managing child behavior challenges, parents of children with ASD
report low levels of individual and couple adjustment. Parents report high levels of depression
and anxiety, and low levels of parental efficacy and couple relationship quality compared to
parents of typically developing children. To address the dual needs of parents for support in
navigating ASD services and maintaining positive family functioning, we propose to test Autism
Parent Navigators (APN), an innovative in-home, peer support model for parents with a young
child recently diagnosed with ASD. APN was designed to be feasible and scalable by relying on
parent peer mentors to conduct sessions. Extensive pilot work over the past 3 years has
generated evidence of feasibility, acceptability, and impact. This pilot work has allowed us to
fine-tune the parent mentor training, participant recruitment, delivery, and fidelity monitoring
procedures.
Aim 1. To assess the efficacy of APN in a randomized trial with 180 families. Aim 2. To test
the mediating pathways through which APN impacts outcomes: We will test whether impact on
proximal targets (ASD-related appraisals; coparenting; parent self-efficacy about accessing
services; and peer mentor support) influence parent mental health, parenting, and treatment
engagement, and if these in turn influence child outcomes. Aim 3. To assess whether baseline
parent characteristics (financial stress, mental health, relationship conflict), child characteristics,
or program processes (fidelity, parent engagement) moderate outcomes.
