Comparison of the Effectiveness of the Incredible Years Program and the Hanen Parent Training Program on Caregiver Burden among Mothers of Children with Autism Spectrum Disorder
Keywords:
Incredible Years Program, Hanen Parent Training Program, caregiver burden, autism spectrum disorderAbstract
The present study aimed to compare the effectiveness of the Incredible Years Program and the Hanen Parent Training Program on caregiver burden among mothers of children with autism spectrum disorder. This study was a quasi-experimental investigation with a pretest–posttest design, a control group, and a follow-up phase. The statistical population consisted of all mothers of children with autism spectrum disorder who referred to the Autism Center in Gorgan. The sample size was calculated using G*Power software based on statistical power (0.80), effect size (50%), and confidence level (0.05), resulting in 15 participants per group; considering the three groups, a total of 45 participants were selected. Sampling was conducted purposively at the participant-selection stage and non-randomly at the assignment stage for the experimental and control groups. The data collection instrument was the Zarit Caregiver Burden Interview. The pretest and posttest data of the study groups were analyzed using SPSS software version 24 through two-way repeated-measures analysis of variance. It is evident that research conducted in any field has a specific purpose and motivation; however, what appears to be important is the outcomes derived from it, which may have practical applications. The obtained results and recommendations are important not only in terms of applying research findings but also in creating and strengthening motivation among researchers and paving the way for subsequent studies and investigations. Taking the above into account, the following section discusses and concludes the research topic and ultimately presents recommendations for researchers who intend to work in this area.
Downloads
References
1. Hayes SA, Watson SL. The impact of parenting stress: A meta analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders. 2013;43(3):629-42. doi: 10.1007/s10803-012-1604-y.
2. Hayes SA, Watson SL. The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders. 2013;43(3):629-42. doi: 10.1007/s10803-012-1604-y.
3. Zaidman-Zait A, Mirenda P, Duku E, Vaillancourt T, Smith IM, Segal O, et al. Impact of personal and social resources on parenting stress in mothers of children with autism spectrum disorder. Autism. 2017;21(2):155-66.
4. Bekhet AK, Johnson NL, Zauszniewski JA. Effects of resilience on the relationship between stress and quality of life in parents of children with autism spectrum disorder. Journal of the American Psychiatric Nurses Association. 2012;18(6):337-45.
5. Jaffar A, Waqar W, Hassan SMU, Ahmed A, Asim M, Zubair M. Caregiver Burden and Psychological Distress in Parents of Children With Neurodevelopmental Disorders: The Mediating Roles of Rumination and Hopelessness. Journal of Autism and Developmental Disorders. 2025;2(4):1-12. doi: 10.1007/s10803-025-07103-4.
6. Demirci SC, Menkü BE, Aksoy N, Öztürk ZS, Özaslan A, Arıkan ZÖ. Resilience and Quality of Life in Families of Individuals With Polysubstance Use Disorder: Mediating Effects of Internalized Stigma and Caregiving Burden. Journal of Family Nursing. 2026. doi: 10.1177/10748407261417986.
7. Mak WWS, Cheung RYM. Affiliate stigma among caregivers of people with intellectual disability or mental illness. Journal of Applied Research in Intellectual Disabilities. 2008;21(6):532-45. doi: 10.1111/j.1468-3148.2008.00426.x.
8. Mak WWS, Kwok YTY. Internalization of stigma for parents of children with autism spectrum disorder in Hong Kong. Social Science & Medicine. 2010;70(12):2045-51. doi: 10.1016/j.socscimed.2010.02.023.
9. Kinnear SH, Link BG, Ballan MS, Fischbach RL. Understanding the experience of stigma for parents of children with autism spectrum disorder and the role stigma plays in families' lives. Journal of Autism and Developmental Disorders. 2016;46(3):942-53. doi: 10.1007/s10803-015-2637-9.
10. Corrigan PW, Larson JE, Rusch N. Self-stigma and the why try effect: Impact on life goals and evidence-based practices. World Psychiatry. 2014;13(2):119-20. doi: 10.1002/wps.20054.
11. Kuhn JC, Carter AS. Maternal self-efficacy and associated parenting cognitions among mothers of children with autism. American Journal of Orthopsychiatry. 2006;76(4):564-75. doi: 10.1037/0002-9432.76.4.564.
12. Dalbert C. Belief in a just world. In: Leary MR, Hoyle RH, editors. Handbook of Individual Differences in Social Behavior: Guilford Press; 2009. p. 288-97.
13. Estes A, Munson J, Rogers SJ, Greenson J, Winter J, Dawson G. Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2014;53(5):580-7. doi: 10.1016/j.jaac.2014.02.008.
14. Rogers SJ, Estes A, Vismara L, Munson J, Zierhut C, Greenson J, et al. Enhancing parent-child communication in autism: A randomized controlled trial of the Early Start Denver Model parent coaching program. Journal of Autism and Developmental Disorders. 2019;49(2):623-41. doi: 10.1007/s10803-018-3743-1.
15. McConachie H, Diggle T. Parent implemented early intervention for young children with autism spectrum disorder: A systematic review. Journal of Evaluation in Clinical Practice. 2007;13(1):120-9. doi: 10.1111/j.1365-2753.2006.00674.x.
16. Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. 2013;2013(4):CD009774. doi: 10.1002/14651858.CD009774.pub2.
17. McConachie H, Parr JR, Team P. Long-term outcomes of parent-mediated interventions in autism: A follow-up of randomized trials. The Lancet Psychiatry. 2021;8(6):499-508. doi: 10.1016/S2215-0366(21)00106-3.
18. McConachie H, Parr JR, Livingstone N, Morris C, Beresford B, Couteur AL. Parent-mediated intervention for young children with autism spectrum disorder: A systematic review. Autism. 2021;25(2):357-72. doi: 10.1177/1362361320951376.
19. Postorino V, Sharp WG, McCracken CE, Bearss K, Burrell TL, Evans AN, et al. A systematic review and meta-analysis of parent training for disruptive behavior in children with autism spectrum disorder. Clinical Child and Family Psychology Review. 2017;20(4):391-402. doi: 10.1007/s10567-017-0237-2.
20. Werner K, Clifford J, O'Hara M. Parent-child interaction therapy in autism spectrum disorder: A systematic review. Clinical Child and Family Psychology Review. 2020;23(2):212-39. doi: 10.1007/s10567-019-00299-8.
21. Tellegen CL, Sanders MR. A randomized controlled trial evaluating a brief parenting program with children with autism spectrum disorders. Journal of Consulting and Clinical Psychology. 2013;81(6):1191-205. doi: 10.1037/a0034860.
22. Leung C, Sanders MR, Leung S, Mak R, Lau J. Effectiveness of the Incredible Years program on parental stress and child behavior problems: A randomized trial. Prevention Science. 2023;24(5):879-91. doi: 10.1007/s11121-023-01542-w.
23. Leijten P, Melendez-Torres GJ, Knerr W, Gardner F. Transported versus homegrown parenting interventions for reducing disruptive child behavior: A multilevel meta-regression study. Journal of the American Academy of Child & Adolescent Psychiatry. 2018;57(7):530-40. doi: 10.1016/j.jaac.2018.03.016.
24. Divan G, Vajaratkar V, Desai MU, Strik-Lievers L, Patel V. The feasibility and effectiveness of parent training for autism spectrum disorder in low- and middle-income countries: A systematic review. Autism. 2019;23(7):1656-70. doi: 10.1177/1362361318803492.
25. Webster-Stratton C. The Incredible Years: Parents, Teachers, and Children's Training Series: Program Content, Methods, Research and Dissemination 1980-2011. Seattle, WA: Incredible Years; 2011.
26. Webster-Stratton C, Reid MJ. The Incredible Years parents, teachers, and children training series: A multifaceted treatment approach for young children with conduct problems. In: Weisz J, Kazdin A, editors. Evidence-Based Psychotherapies for Children and Adolescents. 2nd ed: Guilford Press; 2010. p. 194-210.
27. Hutchings J, Pearson-Blunt R, Pasteur M, Fox E, Williams ME. The Incredible Years parent program with families of children with autism spectrum disorder. Journal of Autism and Developmental Disorders. 2017;47(9):2862-73. doi: 10.1007/s10803-017-3200-6.
28. Postorino V, Sanges V, Giovagnoli G, Fatta LM, De Peppo L, Mazzone L. The Incredible Years Parent Training Program in children with autism spectrum disorder: A pilot study. Journal of Autism and Developmental Disorders. 2020;50(7):2548-62. doi: 10.1007/s10803-019-03975-z.
29. Girolametto L, Weitzman E, Greenberg J. Changes in parent-child interaction after Hanen parent programs for toddlers with developmental delays. Journal of Speech-Language Pathology and Applied Behavior Analysis. 2007;40(1):27-41. doi: 10.1044/1058-0360(2007/004).
30. Carter AS, Messinger DS, Stone WL, Celimli S, Nahmias AS, Yoder P. A randomized controlled trial of Hanen's More Than Words intervention for parents of toddlers with autism spectrum disorder. Journal of Child Psychology and Psychiatry. 2011;52(7):741-52. doi: 10.1111/j.1469-7610.2011.02395.x.
31. Green J, Charman T, McConachie H, Aldred C, Slonims V, Howlin P, et al. Parent-mediated communication-focused treatment in children with autism (PACT): A randomized controlled trial. The Lancet. 2010;375(9732):2152-60. doi: 10.1016/S0140-6736(10)60587-9.
32. Roberts J, Williams K, Carter M, Evans D, Parmenter T, Silove N, et al. A randomised controlled trial of two early intervention programs for young children with autism: Centre based with parent program and home based. Journal of Autism and Developmental Disorders. 2011;41(4):475-88. doi: 10.1007/s10803-010-1062-9.
33. Morawska A, Sanders MR. Parenting gifted and talented children: What are the key parenting challenges? Australasian Journal of Gifted Education. 2009;18(1):33-41.
34. Whittingham K, Sofronoff K, Sheffield J, Sanders MR. Stepping Stones Triple P: A parenting program for families with a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology. 2009;37(4):469-80.
35. Marsack‐Topolewski CN, Wang F, Samuel PS. Characteristics of Adult Children With Autism and Caregiver Burden. Family Relations. 2025;74(2):931-50. doi: 10.1111/fare.13141.
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2026 Niloufar Sadat Bashiri (Author); Seyyedeh Olia Emadian; Seyyedeh Hamideh salim Bahrami (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.