Applied behaviour analysis: does intervention intensity relate to family stressors and maternal well-being?
More weekly ABA hours can cut maternal depression, but heavy parent involvement raises strain—balance dosage with caregiver support.
01Research in Context
What this study did
Fullana et al. (2007) asked a simple question: do more ABA hours help moms feel better or worse?
They tracked families running home-based ABA programs for kids with autism. They looked at weekly therapy hours, how much moms joined in, and moms’ scores on depression and strain.
The team used a before-and-after design with no control group.
What they found
More ABA hours each week linked to lower maternal depression scores.
Yet moms who jumped in and did more of the therapy themselves felt higher personal strain.
So dosage helped mood, but hands-on involvement added pressure.
How this fits with other research
Eckes et al. (2023) meta-analysis of 11 studies found ABA boosts child IQ and daily-living skills, yet shows no clear drop in parental stress. Fullana et al. (2007) adds nuance: hours alone can ease depression even if overall stress stays flat.
Schlink et al. (2022) used fancy stats on toddler parent-training and saw a short stress bump right after moms got hands-on. Their result extends Fullana et al. (2007) by showing the strain spike can be brief and age-linked.
Reid et al. (2019) looks like a contradiction: higher parent depression predicted worse child gains in group therapy. The clash disappears when you spot the setting difference—center-based talk groups versus in-home ABA. Program type, not parent mood, drives the child outcome direction.
Why it matters
You can reassure families that adding ABA hours is unlikely to harm mom’s mood and may even help. Still, watch for overload when parents become co-therapists. Build quick check-ins after high-involvement sessions and share the teaching load across staff and family members.
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02At a glance
03Original abstract
BACKGROUND: Interventions based on applied behaviour analysis (ABA) are commonly recommended for children with an autism spectrum disorder (ASD); however, few studies address how this intervention model impacts families. The intense requirements that ABA programmes place on children and families are often cited as a critique of the programme, although little evidence is available to support this claim. Using Pearlin's (1999) stress process model, this study assessed: (1) whether mothers of children participating in a home-based ABA programme reported elevated depressive symptoms; and (2) whether ABA intensity related to unmet family needs and maternal feelings of depression, personal strain and mastery. METHOD: Forty-one mothers of children diagnosed with an ASD participated in this study by completing questionnaires about their child's ASD behaviours, unmet family needs, and maternal feelings of depression, personal strain and mastery. Additionally, mothers provided information about their child's intervention programme and their own level of involvement in the programme. At the time of data collection, all families had been running a home-based ABA programme for at least 6 months. RESULTS: Single-sample t-tests and multiple regression analyses were used to test the proposed hypotheses. Mothers of children participating in a home-based ABA programme reported more depressive symptoms than mothers of children with other developmental disabilities. Comparisons revealed comparable depressive symptoms between the mothers of the present sample and those in other ASD samples. When considering weekly ABA intensity, mothers reported fewer depressive symptoms when their child was older and when their child participated in more ABA therapy hours. Conversely, mothers who were more involved in their child's ABA programme reported more personal strain. CONCLUSIONS: The findings of this study supported the hypothesis that families participating in ABA experienced elevated depressive symptoms, much like any family raising a child with an ASD, suggesting a potential area for family-level intervention. Additionally, ABA intensity related to maternal depression and personal strain, and therefore deserves continued attention. Future studies should attempt to replicate these findings with a larger and more representative sample and seek to identify mechanisms through which ABA intensity may influence maternal and family well-being.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2006.00940.x