Int J Pharm Pharm Sci, Vol 7, Issue 11, 7-12Review Article

PARENT’S SELF-EFFICACY, EMOTIONALITY, AND INTELLECTUAL ABILITY IMPACTING THE INTERVENTION OF AUTISM SPECTRUM DISORDERS: A REVIEW PROPOSED MODEL FOR APPRAISAL OF INTERVENTION

**VIDYA BHAGAT*, JOASH JAYARAJ, MAINUL HAQUE**

Faculty of Medicine (FP), Universiti Sultan Zainal Abidin (UniSZA), 20400 Kuala Terengganu, Terengganu, Malaysia
Email: 55vidya42@gmail.com

Received: 25 Jul 2015 Revised and Accepted: 03 Oct 2015

ABSTRACT

Autism spectrum disorder (ASD) may affect all domains of a child’s life. Indeed, it impacts not only the child but also parents and siblings, causing disturbances in the family. The experience of parents with an autism spectrum disorder can be devastating; they have a demanding need to cope with complex situations in their lives. The presence of pervasive and severe deficits in children with ASD increases the adjusting demands of parents in their life situations, thus, nudging them into distress which in turn incapacitate them and lowers their efficiency to deal with these situations thereby reducing their self-efficacy. These parents are found with disturbances in emotional and intellectual components of their personalities. They end up being shattered in their interpersonal relationship and family life. Indeed, these aspects of parental distress rank lower in position and the focus rests on the treatment of ASD. Thus, the management of ASD incapacitating the parents of the deficit children to reach their fullest abilities remains questionable. Therefore, the objectives of this study are a) to examine the impact of emotionality, intellectual ability and self-efficacy of the intervention of autism spectrum disorder. b) To propose a new intervention model for ASD incorporating self-efficacy, emotional and mental ability c) To suggest the integration of this new model with the current intervention regimens to ensure better efficacy. This study, based on past evidence has keenly, examined the correlation of intellectual ability, emotionality and self-efficacy with the intervention of autism spectrum disorder. The results reveal that emotional and intellectual disturbances and impaired self-efficacy in the parents of children with ASD have an adverse impact on the intervention of ASD. A new model of intervention for ASD encompassing the above-mentioned essential components of parents’ personality has been proposed, and its integration with the existing treatment regimens has been suggested to reap an improved outcome. The study concludes by observing the fact that considerable improvement in the diagnosed child may not ameliorate the parent and family distress already present, especially at the time and expense of intervention can be even more detrimental to the overall personality of the parents. The new proposed model of intervention can pave the way for further research in this regard.

Keywords: Autism spectrum disorders, Parent’s emotionality, Parent’s intellectual ability, Intervention.

INTRODUCTION

ASD is a neurological and developmental disorder. The characteristics of this disease are consistent impairment in social communication, interaction as well as repetitive stereotype behaviors. The pervasive and complex deficits often present in children with ASD. Further, this also nudges their parents into a plethora of difficulties. Such as increased parenting stress, reduced parenting efficacy, and increased mental disturbance affecting emotional and intellectual domains of their personality. The current study had reviewed the prevalence of ASDs, which has been observed; there are 6.7 cases per 1000 children out of which 4 cases per 1000 children had met full diagnostic criteria for ASD [1].

This constellation of symptoms is intrusive in nature, present during early childhood, and compromises their everyday functioning as well as affecting these children throughout lives. The stage at which functional impairment becomes vivid will differ based on the characteristics of each child with ASD. Child’s environment also plays a significant role. The key diagnostic features in these children are noted in the developmental period, but intervention, compensation, and currently supports and difficulties are ambiguous in some disciplines [2]. The prevalence of autism and related ASDs is remarkably higher than previously noted. The increase is due to better ascertainment, expanding diagnostic criteria, or increased incidence is hazy. Health and social welfare organizations must identify and cater to the needs of children with ASD [3]. The observed prevalence rate in Asia, as reported in recent studies was higher than previously described. The average prevalence of ASD before 1980 was around 1.9/10,000; presently it has increased to 14.8/10,000. The median prevalence of ASD reported in China from 2000 upwards was 10.3/10,000. Thereby, it is found to be more common in Asia [4].

There is a relatively high preponderance of males than females in ASD. Presently many research is enthusiastically working for to grow with a better understanding of biological mechanisms of ASD. However, research on interventions intending to help ASD child and their families with their psychological parameters are limited even in the advanced world [5-6]. Further, some literature analyzed information upon which health services, family members, and researchers could make decisions to adopt new models with increased efficiency [5]. In the USA, the diagnosis rate of ASD in the has shown a steep rise in the past three decades. The US researchers are taking more interest to find the biological and genetic markers of the etiology and manifestation of ASD. The intervention in ASDs made with the involvement of parents needs to incorporate self-efficacy, emotional and intellectual balance. Many intervention programs currently operational involve parents in the intervention program to get the best outcome.

Today, most of the intervention programs are fortified with parental involvement in the response of ASDs. Parents and family members of ASDs are provided with the information. So, they also involve the decision-making process which often plays a vital role. Consequently, parents use intervention techniques with their child to teach positive skills and reduce undesirable behaviors that disrupt the family stability. Thus, the collaboration between parents and therapist go hand in hand to obtain the primary objectives through a structured training program [7]. The parents’ participation improves their self-efficacy and balance in emotional, intellectual component of their personality are significant. Thus, the current review study proposes that the new Interventional method should focus on these components of parents in addition to the child’s treatment that assumes significance in understanding the treatment effectiveness.

Parenting stress in parents of children with ASD

Parenting process is significant in endorsing and fostering the physical, emotional, social, financial, and intellectual development of children from infancy to adulthood. This process not only share the biological relationship with their children but also raise them to independent, unique personalities. This task is not an easy one; thus stress is quite common in parenting. But the coping pattern varies with the amount of pressure and parental ability to cope with the stressors. Parents of ASD children need to deal with additional adjustment to their demanding life situations. Higher levels of stress are evident in these parents. Parents rearing children with ASD are known to experience higher levels of parenting stress than parents of typically developing children [8]. The current review examines’ past evidence and found that parents of children with ASD experienced higher stress levels. The parents of neurodevelopmental disorder found with higher stress levels while adjusting with behavioral problems and cognitive abilities. There are many potential deficits and comorbid diagnoses associated with an ASD diagnosis, meaning that there are many different faces of the disorder that may be related to parenting stress [8]. Further, the current review examines’ the factors contributing to parenting stress in caregivers of children with ASD are multi-faced. These include the presence of child anxiety, behavior problems, irritability, dependence, hyperactivity, noncompliance, poor self-care and adaptive functioning. Additionally, language deficits, learning disability, enforced limits on family opportunities, need for care across the lifespan, inappropriate eating, toileting, and sexual expression, and broad social difficulties may also contribute to parenting stress [9].

Further, the current review observes that there is a difference in an impact of individual symptoms of autism on parents, which has been assessed accurately and which estimates the level of parents' perceived stress. Mothers and fathers of autistic children who work in collaboration with therapists are independently rated. The severity of common symptoms of autism in their child, and how stressful each of these symptoms impacting parental stress could be has been estimated by these therapists. Specifically, the language and cognitive impairment were found to be more severe and stressful. Parents demonstrated a degree of stress, which was associated with symptom severity in their children. It has been observed that the effect of this pressure on these parents made their segregated from their family and friends [10]. The current review examines’ the particular construct contributes to parenting stress and how the latter changes over the course of the child’s development. As well as how the overall stress levels in parents of children with ASD are stable over time [11].

One of the examined reviews reveals the relationship between parenting stress and self-perception of parents’ concerning their parenting. Parenting stress closely interacted with self-perception of parents about their limited involvement and poor communication with their children. In parents of younger children, the higher levels of parenting stress impacted less subsequent self-perceived relationship and poorer communication, with their child [12]. Present studies overview the aspects of stress as depicted in the earlier studies. Here, several researchers have found parenting stress to be significantly impacted by the association between the coping strategies and the extent of social support received by these parents [9].

Therefore, the fact that treatments that boost enhanced parental support and those which heighten hopefulness for parents could be helpful in reducing their stress, in particular, warrants attention. This can pave an impact on parental emotions, intellect, and self-efficacy. Current review notes that alleviated stress and active parental role can facilitate the intervention program to target and successfully, treat subclinical deficits in ASD children. Broader autism phenotype (BAP) or sub-threshold characteristics of autism often seen in children with ASD. Here parenteral stress linked with impaired social abilities, poor eye contact, and restricted or narrow interests. [9]. Thus, the current study reviews the areas affecting child’s Interventional outcome. The present study examines’ in the supportive literature that evidences that high levels of parenting stress are associated with poor Interventional outcomes over a period of the treatment of children with ASD [13]. Moreover, it has been observed in recent evidence studies that parental respite was associated with decreased hospitalizations for children with ASD. Thus, interventions that reduce parenting stress can benefit the children with ASD and also, the family as a whole [9]. Current review analysison past evidence has keenly examined to analyze the parents intellectual ability, emotionality and self-efficacy and its effect on the intervention of ASD.

Impact of ASD on parent’s personality

Parental self-efficacy

Parental self-efficacy is a belief that one will be able to perform parenting tasks successfully which has been found to be vital for parenting quality. In addition to parental self-efficacy is often associated with greater competence in performing parenting tasks. Parents’ self-efficacy is important in coping with stress and balancing emotions and in intellectual adaptation to the situations encountered in parenting. The demanding conditions stressing the parents of children with ASDs are typical in their child rearing. Thus, parent’s self-efficacy is a significant attribute for, effectively, parenting the child, regardless of the presence or absence of disability in their children. The current review study examines’ the above fact in the past evidence and found in the studies that parental self-efficacy may impact actual parenting behaviors. It has been proven that the parents of normally, developing children have an insight that parenting, self-efficacy predicts the level of parenting competence. Further, it has been examined that effective parenting in the context of defiant child behavior has demonstrated better capability [6]. The association between psychological components of parents and their self-efficacy in parenting ASD children is well established. The current study has reviewed the fact that the alteration in mental equilibrium can blur the individual perception of self-efficacy [14].

It is difficult to accurately, define parental competence predominantly, due to the robust overlap of the concept with that of other psychological components such as parental confidence, parental and maternal self-efficacy. While some authors debate on the distinctness of the ideas, others contend that most researchers, irrespective of the term they use, seem to be studying a construct simulating self-efficacy. [15]. However, current review analysis emphasizes on parental self-efficacy and its importance in parenting competence. Thus, the present study examines’ self-efficacy and its’ significance in determining effective parenting of children with ASD. This fact gives an insight that self-efficacy has been noted as a hallmark in the general parenting which affects parent outcomes. Twenty-six mothers and 20 fathers of children with autism rated their self-efficacy, anxiety, and depression.

The behavior problems of children were assessed by the teachers. On employing regression analyzes, the data revealed that self-efficacy moderated the effect of child behavior problems on maternal anxiety and depression, but there was no correlation with the depression in fathers. But, there was ample evidence that self-efficacy mediated the effect of child behavior problems on fathers' anxiety [15]. Parenting self-efficacy or one’s belief in his or her ability to parent effectively also appears important to assess given the high likelihood that parents of children with ASD experience decreased confidence in their parenting skills. Weak parenting, self-efficacy has been associated with increased levels of parenting stress. The parents having a child with ASD are entangled in a web of problems which induce stress often and, thereby, lack confidence in helping their child. Further, these parents are also at risk of developing depression and anxiety in the process of raising a child with ASD [15]. The current review also examines the fact that self-efficacy and its impact on various aspects of parent personality issues like their confidence level, parenting skills, anxiety and depression in parents and so on.

The current review analyzes that the standard mode of life of families constitutes promising opportunities for personal growth. It is important for parents of individuals with Autism Spectrum Disorders to understand this fact. The observed evidence emphasizes to parents having a risk of considerable distress coping with multiple stressors. The current study examined family hardiness, perceived social support and parent self-efficacy as predictors of family distress in mothers of children with ASD. Present study analyzes that perceived self-efficacy and social support mediated the relation between the accumulation of stressors and family hardiness. Family hardiness was associated with family distress. Researchers and clinicians should appreciate the role that perceived social support and parent self-efficacy play in ascribing family hardiness as psychological components [16].

The standard issue observed in these parents is that they are often frustrated with their child’s behaviors and skeptical about their parenting abilities. This perception of parents of their self-efficacy is demonstrated in the parents of a child with ASD due to their child’s poor social communication that is a hallmark pitfall of ASD. Parents also suspect their abilities in fulfilling the emotional needs of their children with ASD, who lack clarity in expressing such needs due to impairments in their verbal and nonverbal communication [17]. Further, the current study has reviewed the significance of parents ‘self-efficacy and its impact on children with ASD. Thus, a parent management training program designed to increase parents’ self-efficacy can be successfully planned. They found that parent’s attending individual treatment sessions reported increased self-efficacy and significant improvement, especially, in maternal caregivers [17]. It has been examined in the present study that child behavioral problems were found to be considerably less following an intervention program that increases parental self-efficacy in parents of children with ASD impacting the diagnosed child. It is understood that there are adequate reasons to believe that parents of children with ASD suffer from decreased parental self-efficacy. However, an increase in parental self-efficacy was observed through interventions that seem to positively impact parents and their children with ASD. Thus, it becomes necessary to take this variable into account in understanding its overall effect on ASD interventions [17]. The scrutinized evidence reported that a parent-focused intervention led to greater improvement in parental self-efficacy and also demonstrated that parents were more self-directed in the intervention program [18].

One of the examined studies evidenced that the positive parenting is a promising intervention for parents of children with ASD. The results demonstrate significant improvements observed in parental reports of child behaviors and parenting styles and its impact on treatment effectiveness. Parental over-reactivity and verbosity have been negatively correlated with the child’s behavior. Also, improvements were noted in parental satisfaction and conflict resolution about parenting as well as a sleeper effect on parental efficacy [19]. Current review analyzes the fact that how self-efficacy of parents affects child’s behavior.

The current study probes into studies that ponder on measuring the parent self-efficacy and its usefulness in ASD intervention that focuses on parental abilities in the program. In this era, the various parenting, self-efficacy instruments were specially developed for research in this area. The PSE instrument was based on Bandura’s self-efficacy theory. The PSE is composed of three dimensions: level, strength and generality [20]. The test items consist of day-to-day infant care tasks as well as their interactive behaviors. Here the level refers to task difficulty, strength to the person’s degree of confidence and generality to the modalities in which different functions are expressed. The selected three patterns of this test support the parental practice of the affective, cognitive and behavioral skills related to PSE [20]. Thus, the current review emphasizes on parental self-efficacy which has significance in the intervention of child with ASD. It has been explored in the past evidence that the improved outcomes with early behavioral intervention have placed the initial treatment of autism as an important priority. However, long waiting lists for treatment often preclude timely access and raise the question of whether parents could be trained in the interim. Parent training in PRT is indispensable in enhancing the communication skills of children with ASDs. [21]. Current review analyzes that such training for parents of a child with ASD needs self-efficacy in these patients to attain better results.

Emotional component

The present study examines that the relationship between parenting behaviors in parents of children with Autistic Spectrum Conditions which pervades into child’s behavior problems. The emotional aspect of personality has been emphasized in parenting. The emotional component is one of the important aspects that need to be focused on the intervention of ASD. The current review examines’ the personality which has been investigated. In one such example study of raising a child with an ASD, which presents significant challenges for parents that potentiate the impact on their health and wellbeing [22]. The current study further analyzes the extent to which parents experience fatigue and its impact on other aspects of parental welfare. The mothers of children with an ASD reported significantly higher fatigue. Factors associated with high levels of fatigue were poor maternal sleep, physical activity, and social support. Further, it has been examined that the fatigue has an impact on various aspects of parents’ well-being, including stress, anxiety and depression and lower parenting efficacy [22].

Disturbances in felt emotions in the parents of a child with ASD may result in the undue delay in diagnosis and treatment of the child because of parental unstable emotional behavior. The study examines and explores the fact regarding parental feelings of children with ASD. The evidence observed the ASD etiology in conjunction with a plethora of different interventions available for ASD. Thus, it leaves parents in conflict, feeling uncertain and confused about the optimal duration of treatment for their child. Further, it has been observed that this insecure feeling in these parents who has employed minimally, effective parenting strategies for relatively extended periods of time results in a delay in ASD diagnosis [23]. Emotionality is an important component of mental stability which impacts parents of children with ASD and their wholesome involvement in effective parenting and their participation in the intervention program. Disturbances in this part of the personality may reduce their efficiency in this regard. The current study examines the related aspect of emotionality which resulted in lowered self-contentment in these parents. The need for interventions to specifically target parental fatigue and its role in impacting the families of children with ASDs has also, been discussed [24]. Parents of children with ASD commonly, report higher levels of parenting stress and greater affective symptoms when compared to parents of typically developing kids and parentages with other disabilities [25]. In the current review analysis, it has been clearly observed that stress and emotionality are affecting the health of paternities with ASD children. This can affect their fullest involvement in intervention programs conducted for their child with ASD.

The present review examines’ the emotional stress in mothers of children with ASD. The suggestion found here that African American mothers perceived a higher negative impact of having a child with ASD. These moms were assessed and found to have less perceived social support. This predicts greater negative impact which has been focused on designing interventions to support families and target parents who may be vulnerable to experience high levels of stress [12]. Emotionality and related problems in the personality of parents with an ASD child examined in the exemplary study. Here the comparison made between the children with the developmental disorder and their parental characteristics revealed that the autistic children play a crucial role in the genesis of autism. The current study had observed the relationship between parental characteristics and environmental stresses in the autistic group which contained a large proportion of middle-class families. But no evidence was found in the differences between the groups concerning parental warmth, emotional responsiveness, sociability and any other stresses. The current study also appreciates the notion that it is unlikely to develop ASD as a consequence of such parental personality traits [26]. One of the examined research studies sheds light on parental emotional expression in a child with ASD. In this study, the performance on an emotional labeling task in response to schematic facial patterns representing five basic emotions was investigated in parents of children with ASD. It is found that father’s performance was worse than f mothers in decoding displays representing disgust. This study also opens up a need to include facial expression decoding tasks in the genetic research of autism. The significance of such research on emotional expression and the interactions between parents and their children with autism, particularly through play, promote the development of social competence in these children [27]. Current reviewed research on its examined facts finds emotionality affecting personality trait of parents of a child with ASD also its significance in promoting social competence in these children.

Current review research has explored that self-efficacy has known to be an important variable affecting parent outcomes in the management of children with ASD. It effectively predicts mothers' anxiety and depression. Examination of the evidence showed gender differences in this regard [15]. The current review examines’ that stress and emotionality also lead to substance addiction as a result of fleeing response to stress. The induced negative emotions may, in turn, reduce parental efficiency in their parenting of children with autism. Evidence also reveals higher rates of alcoholism in parents of children with ASD [28]. Scrutinizing and examining the past evidence has polished the understanding of coping strategies in parents of children with ASD. The coping strategies in parents’ with children with autistic spectrum disorders and the relation between these strategies and parenting styles have been studied. Here, the significant differences between the emotional gradient and cognitive gradient were observed, and it has been found that the mothers’ level of coping was much higher for the cognitive gradient than that from the emotional angle. The gender difference in the emotional gradient was demonstrated by a higher sense of coherence among the fathers and, probably, a stronger burnout effect among the mothers [29]. Here in the observed fact the reviewer finds the presence of emotional and cognitive gradients in the parents of a child with ASD. Further feasibility on these graded traits can be made more suitable for intervention?

Cognitive component

It is a fact that cognition and emotion are intimately associated, and the role of cognition in emotional distress needs to be focused on the treatment of ASD. Parents of children with autism spectrum disorder are at risk for high levels of distress. Focusing on the cognitive component of the personality of parents with ASD child in the current review examines’ the turbulences in the cognitive component affect various perspectives of parents of children with ASD [30]. Further, the phenotype in ASD has been analyzed basing past evidence, and the findings have suggested that the possibility of broader autism phenotype may include a cognitive flair that can offer information-processing advantages [31]. Evidence also reveals that siblings of ASD children have a broad phenotype, lower IQ scores and poor reading and spelling performances.

However, the cognitive difference and the lack of a distinctive cognitive profile warrant the need for further researchers to operationalize this definition of the broad phenotype of autism [32]. The extent of parent’s involvement in the therapeutic program depends on their cognitive ability. Parental decision making determines the Interventional outcome at times. This study has made an effort in exploring the past evidence on the schedules established for an autistic child who stresses on child’s therapy schedule and its need for continued revision. Further, it also emphasizes on the consistency and education of both the parents. Thus, the decision-making is structured for the smooth processing of therapies, modification of programs and other interventions [33]. The current study also analyzes the previous evidence that had studied about the limited scope for promoting the hidden agendas of parents who still have unsettled issues of their marital discord. Parents severely compromise Parents' emphasis on their autistic child and development concerning their personal issues. Thereby parental decision-making process is neither stalemated nor crippled [33]. Current study analyzes the facts based on evidences that parent’s cognitive strength and ability to gain insight into problem solving helps the intervention of ASD child. Further, emphasizing in finding out the feasibility of introducing the programs for these parents to improve their cognitive strength.

Examination of parents’ perceptions as an important component of cognition revealed its association with the ASD child’s emotional aspect. The study analysis of reviewing the facts of parents’ perceptions and their children's emotional expressiveness showed more negative emotion and less positive emotion in the children with ASD. In the younger sample, parental attitudes correlated with the children's attention and responsiveness to others' display of emotions. This evidence has contradicted the view that autism involves the absence of emotional reaction [34]. The current study examines parent perception. The satisfaction of parents with ASD children with regard to the education were highly appreciable when the school personnel effectively manage children’s behavior. However, teacher training and understanding of the disability, effective communication, as well as teamwork between parents and teachers was found noteworthy [35]. Parental perceptions of the importance of friendship development in comparison to other outcome priorities are examined in this research. Parents of children with high functioning autism were asked to consider the outcome priorities of friendship, social skills, physical development, motor development, intellectual ability, academic skills, creativity, and emotional capacity. It was predicted that friendship would be highly prioritized by parents, considering the friendship difficulties often experienced by children with autism. Parents’ rated outcome involving social skills, emotional skills and friendship that is third in the order, although all the three components were closely rated. However, the autistic symptomatology was not influenced by this parent rating [36]. This review study learns that the along with parent rating influencing autistic symptomatology, the evaluation of these parents in their parenting style and various aspects affecting their parenting should be emphasized.

Furthermore, this study has examined the parent’s perception of child behaviors and its significance in therapeutic gains; their involvement in the therapy and insight into therapeutic benefits has been explored. Autism spectrum disorders are depicted with its characteristic features that are impairment in communication, abnormal social interactions, abnormal responses to sensory stimuli, and restricted repetitive and stereotyped behaviors. Active interventions are vital in this case even though there is no predictable prognosis for this disorder. These active interventions include family involvement that brings about positive changes in this ASD child [37]. Further, the analytical results reveal the significance of music therapy in an effective treatment for children with autism spectrum disorders. Examining the parents' perceptions of music therapy discloses the positive responses of parents. This intervention was able to articulate new insights about themselves and their children. Therefore, music therapy would be a potential source to gain further advancement in this area [37]. It has been realized in the current review examination, the need to improve on parental perception of these children thereby facilitating intervention.

The current review examines’ the parental engagement which involves their communication with teachers. This will be assisting them to establish the expected boundaries for the child. The evidence also reveals that the mothers of these children demonstrate a robust desire to contribute to their child’s schooling. [38]. Here current review analysis finds the need of cognitive balance to give their best in helping their child communicating well with teachers to expand the scope for their child’s overall growth.

Conclusion and integration

Autism Spectrum Disorders are common in the general childhood population, which is a serious and lifetime problem. Incredible advances in the treatments of ASD have come up in recent years; the psychological interventions, in particular, have well progressed. The amount of time and cost involved in planning these interventions, particularly parent training and involvement is an incredible option. This review study is a status report on evidence-based methods that are available for training parents of children with ASD as therapists. Current trends and future directions are debated in this study. Insight into the personality components, voice the need for thoroughly examining the relation between these components and parental involvement in the management of their child with ASD with its impact on intervention. Ultimately, it yields a better understanding of these relationships to focus on the formulation of modified interventions and improve the scope of studies evaluating the outcome of therapies for ASD.

A new model of appraisal of intervention for ASD recommended considering personality components of parents with autistic children. On this base, this research reviewed the points above and suggested that (1) ASD is severe, persistent and dynamic; (2) These deficits are associated with parent’s emotions, intellect, and self-efficacy. (3) The impact of ASD on parents possibly has a reciprocal negative effect on children with ASD. (4) There is a broad range of interventions open for children with ASD, encompassing parent and family involvement, which is most necessary for effective therapy. (5) Evaluation of ASD treatments is often limited to an assessment of the child, without consideration of parent personality components.

After reviewing the hitches related to the interventions for ASD, it is suggested new measures. Here the expected outcome in autism should be a high priority in order to frame the goals and effects of treatment. The highlighted area in this study has been extended to personality factors of parents and appraising them as a part of the newly recorded model. The current review examines’ the problem encountered in parenting, is not only in the biological relationship but also in raising them to independent, unique personalities. The coping pattern differs with the amount of pressure and parental ability to cope with the stressors. This found to have a link with self-efficacy, an intellectual and emotional aspect of personality. Thus, this study recommends focusing on an appraisal of stress in parents of children with ASD and its effect on their personality components and self-efficacy.

This study addresses the need for strategies with additional parts of the intervention to inculcate betterment in the intervention of ASD. This study had addressed the daily challenges faced by parents of children diagnosed with autism spectrum disorder. A thematic analysis of the data identified three essential core categories concerning the appraisal of parent personality who need to get involved in the intervention program of their ASD child to the optimal level. These fundamental types are parent’s intellect, emotions, and self-efficacy. The findings emphasize the areas where the parents themselves believe they would require additional support. It gives way to key strategies and resources that parents have found helpful. Caring for children with autism spectrum disorders is challenging and affects family life. Studies that have included assessment of parent outcomes have typically assessed parent-training interventions, but limited studies have evaluated parent personality components, self-efficacy and furthermore, their close association with the treatment outcomes seen in children with ASD.

Knowing more about how various ASD treatments impact parents and families is of prime necessity. The proposed model should not only be applied to modalities of intervention but also directed towards parent and family involvement. In fact, many therapy models incorporating caregivers, such as parent training models, have included some evaluation of parental outcomes as they are the direct beneficiaries of treatment in these instances. The major void in current ASD intervention research is within therapeutic contexts that do not directly involved but undoubtedly affect, parent and family functioning. The intensive nature of most ASD interventions suggests a need for better understanding of the mechanisms of treatment which brings change for the better. Thus, the recommended strategy will facilitate boosting of the understanding regarding the parent personality components. It can also, help in gaining improved self-efficacy and pave a way in helping the child with ASD to get optimal benefits. However, long-term treatment and follow-up research are often restricted by inadequate understanding of therapeutic benefits and the components involved in limiting the advantages and the difficulties in overcoming the complexities of the intervention and related research has been stated in the present study and recommending improvement of the understanding as to how changes are maintained in assessment and treatment outcomes.

Therefore, the classical intervention that focuses on personality components and self-efficacy of parents with ASD children is suggested. This model is intended to be prescriptive in nature. It encourages those engaging in the ASD intervention and research to focus on personality aspects of parents with ASD. It enriches as parenting to the optimal level and their participation in the management program to the best possible magnitude. The suggested intervention program focuses on these parents’ personality components, namely emotion, intellect and their self-efficacy. The appraisal is done in this area to know the disturbances in this field, further to be verified by related research. Moreover, this appraisal is done to resolve this problem and groom these parents in their parenting and enhance their participation in the intervention program. The Intervention for parents to work can be supplemented with hypnotherapy, cognitive hypnotherapy, yoga, individual psychotherapies and supportive programs by the government and other health enforcement agencies (fig. 1).

Fig. 1: The components personality proposed for verification

The proposed model helps to overcome the omissions that had resulted in an inadequate understanding of the therapeutic impact as well as factors contributing to the long-term maintenance of sustained growth following treatment (fig. 2).

Fig. 2: The proposed model for intervention for ASD children

Ultimately, the incorporation of this treatment strategy provides the clinician a way to assess the overall functioning of the parents of these children from the beginning of treatment till the end. Further, it also exerts control over regular planned follow-up visits after the completion of an intervention program. Prior assessment of variation in the personality components (cognitive and emotional) and their self-efficacy will help the clinician to more speedily detect the area of concern. It can help us to understand factors that are likely to hamper the progress, and recommend for the suitable changes.

Incorporation of parental factors in therapy outcome in this research study would help to fill the neglected area in the treatment and the follow-ups. It is also vital in structuring the environment belonging to the ASD child who is involved in the intervention. The parental role in this regard is significant because parents' societies have traditionally been major in this field. The current research support and advocacy have been gained with the help of parents and supporting health organizations. These organizations have already attained remarkable advancement in terms of research, especially in funding new investigators and beckoning eminent scientists from other fields in studying the disorder with different perspectives. The current review study proposes and recommends parental appraisal of their personality components (cognitive and emotional)and self-efficacy. It enables them to get involved in the intervention and improve the parenting style in accordance with their intervention homework. Further, the variables recommended in this model should be assessed for both main and interaction effects to refine confinement and to understand the multifaceted and the symbiotic relationship between the paradigms.

Moreover, additional variables can and should be added if they contribute to the therapeutic benefits. If similar outcome measures are utilized, this would eventually allow more comprehensive comparison between ASD treatment strategies developing healthy parental personalities. Thus, they can cope better and work more efficiently with better cognition, stable emotions and increased self-efficacy in their parenting and involvement in the intervention to obtain the best possible benefits. Appraising and analyzing the personality components and self-efficacy of parents to gain the best result in the intervention of ASD is a Herculean task. It has to deal with the treatment of ASD child, and the jeopardy of not doing so when evaluating the effectiveness of ASD interventions far overshadows the flagrancy of the task required. However, the appraisal of these spelled components would explore the further benefits of the intervention and pave the way for future research in this regards. However, with all the limitation being considered, clinicians work and further studies in this regard is beneficial in the interventions of ASD and encourages implications for future research and practice based on these findings.

CONFLICT OF INTERESTS

Declared None

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