Evaluating the acceptability, feasibility, and short-term effects of a coach-supported, online parenting program (‘PiP Kids-Autism’) for parents of autistic children, targeting child depression and anxiety.

The intervention, ‘Partners in Parenting-Kids Autism’ (PiP Kids-Autism), is an adapted version of the web-based parenting program ‘Parenting Resilient Kids’ (PaRK; ACTRN12616000621415), since renamed 'PiP Kids'. The original PaRK program is an online parenting program designed to equip parents with evidence-based parenting guidelines to respond to anxiety or depression in their child. PiP Kids-Autism has been adapted to empower parents to prevent or reduce depression and anxiety in their autistic child. The PiP Kids-Autism intervention has two components: 1) a web-based program drawn from the PaRK intervention, which includes a parenting self-assessment with tailored feedback about the parent's current parenting practices, and up to 15 web-based modules; and 2) a coaching component delivered via videoconference, henceforth referred to as ‘coaching sessions’. The web-based program includes 15 self-directed online modules covering topics related to parenting an autistic child in the context of reducing the child's anxiety and/or depression, which parents are recommended based on their responses to the self-assessment parenting scale and their own preferences/interests. Modules are based on a range of information including topics such as Autism fundamentals, managing behaviours and emotions, showing affection, setting family rules, managing conflict, managing internalising behaviours, setting goals and when to seek help. The coaching component involves parents attending up to 8 sessions, of which the first includes an orientation component before educational materials. The coaching will be held with a PiP coach via videoconference. The aim of the orientation component is to discuss the program objectives and boundaries with the parent and build rapport. PiP coaches are provisional psychologists completing a PhD (Clinical Psychology) or Master of Clinical Psychology at Monash University. All coaches will receive an intensive training program which will include online learning materials and live and/or recorded role-play exercises with feedback. Additionally, coaches will be provided with ongoing support and development through regular supervision with a registered senior psychologist who is a Board-approved supervisor by the Psychology Board of Australia. The initial coaching session will take up to 90 minutes to allow enough time for coaches to gain a good understanding about the child and parents needs. All other coaching sessions will take approximately 50-60 minutes. Parents will complete coaching sessions weekly. Coaching sessions are manualised to ensure standardised delivery of the intervention. Parents will receive the following as part of the PiP Kids-Autism intervention: 1) Parents first complete two online self-assessments of their parenting practices which will take approximately 25 minutes to complete (The Parenting to Reduce Child Anxiety and Depression Scale - Autism; PaRCADS-Autism and the Parent Self Efficacy Scale - Autism; PSES-A). The original PaRCADS was developed as a criterion-referenced measure to assess parenting against a set of evidence-based parenting guidelines for the prevention of child anxiety and depressive disorders (Sim et al., 2019). The PaRCADS-Autism has been adapted specifically for use with parents of autistic children. Parents will rate their own parenting practices on domains such as their involvement in their child's life, how they manage conflict and how they help their child manage emotions. Responses will be rated on a 5-point likert scale ranging from 'almost never' to 'almost always'. The original PSES measures parental self-efficacy in parenting to reduce the risk of adolescent depression and anxiety (see Nicolas et al, 2020). The PSES-Autism has been adapted specifically for use with parents of autistic children to measure parents' confidence in parenting to reduce the risk of depression and anxiety in their autistic child. Responses will be rated on a 4-point likert scale ranging from 'not at all confident' to 'very confident'. 2) Based on parents’ responses to the PaRCADS-Autism, parents receive an individually-tailored feedback report. The feedback highlights areas of parenting strength and/or confidence, and provides practical strategies for identified areas for further development. The feedback report is displayed to parents online via their 'personal dashboard' as part of the program. 3) Parents will receive at least 6 core compulsory modules and in addition are recommended up to 9 other interactive online modules (a total maximum of 15 modules). Besides the core modules, all recommended modules will be based on each parent’s identified areas for further development (PaRCADS-Autism & PSES-A scores), but will remain optional. The modules provide practical strategies to support parents to make changes to their parenting to align more closely with the parenting recommendations in the evidence-based and expert-consensus-based Parenting Guidelines, and evidence-based content curated to support parents in reducing depression and anxiety in their autistic child. Parents can tailor their program by selecting additional modules, as well as those recommended to them. Parents will also be able to de-select recommended modules if they choose. A total of 15 online modules will be available to add to their personalised program. By default, modules will ‘unlock’ (i.e. become available for parents to complete) at a rate of one module per week, until all selected modules have been unlocked. Parents are notified by email and SMS (if they opt in to SMS notifications) when a new module unlocks. If they prefer, parents can choose to override the default unlock date, and unlock modules at an earlier date. After all initial core and recommended modules have been unlocked, all remaining modules, including those not initially recommended, will become available for parents to complete if they wish. Parents can revisit any modules they have already completed at any time. The interactive modules can be accessed online, from any device with internet access (including smartphones). The modules include educational materials, illustrations, audio clips, videos, interactive activities, goal-setting exercises, and an end-of-module quiz with immediate feedback to consolidate learning. Each module takes approximately 30 minutes to complete, depending on the topic and how parents engage with the module. Parents are invited to complete their first module immediately after they have completed their baseline survey, received their personalised feedback report and selected their modules for the program. 4) Parents will receive coaching sessions with a PiP coach via video-conference approximately weekly whilst completing the modules. Parents have up to 12 weeks to complete a maximum of 8 coaching sessions. In each session, parents will be guided by their coach through a check-in, a review of the online-module content, completion of an activity, and a goal-setting exercise, with a view to work towards their selected goal between sessions. Post-session, parents will have access to a collaborative coach-parent document, akin to a guided reflection/learning record. Intervention adherence will be monitored through website analytics (module completion) and attendance records (coaching sessions). The intervention period is anticipated to run for up to 15 weeks. Note. Children will not be directly involved in the intervention or coaching sessions.