Mindful-Cognitive Strategies and Well-Being in Caregivers of Children with

AutismAshley Arbuckle, OTS and Elizabeth Larson, Ph.D., OTR

Occupational Therapy Program, Department of Kinesiology University of Wisconsin-Madison

Background• Caregivers of children with autism

experience unique daily stressors that lead to poor parental health & well-being.1

• These caregivers often have limited time & access to available resources.

• Evidence shows benefits of cognitive strategies based on positive psychology & mindfulness in various populations. 2

Purpose of Study• To understanding the usefulness of

mindful-cognitive micro-strategies, delivered on an ipad, for caregivers of children with autism.

Key Concepts• Mindful-Cognitive Micro-Strategies

- Short (5-10 minutes) strategies based on mindfulness evidence.

• Mindfulness - Paying attention on purpose, in the present moment, & without judgment.

Participants 5 female married caregivers of children with autism aged 12-18•Education: bachelor to doctoral degrees•Incomes: $50,000 - $100,000•Ages: 45 - 61 years of age•Parenting 1-2 children

•My research mentor: Elizabeth Larson•My research teammates: Vanessa Eisch; Kayla Larson

Laura Hewitt; Brenna Patterson; Yeojin Choi•The participants in the study•Funders: Virginia Horne Henry Award•My husband: Jason•My parents and sisters: Debbie, Frank, Tiffany & Jessica

The caregivers liked the mindful-cognitive micro-strategies as designed and deliveredon the ipad app. Unfortunately, personal and technological barriers prevented the caregivers from being able to use the app. The data also revealed that the caregivers’ hyper-vigilance acts as a significant barrier to mindfulness. However, they identified a desire and need to be more mindful about themselves and their family time. This along with their positive change in perspective over time shows that they have the beginning elements of mindfulness.Occupational therapists can help caregiversof younger children with autism replace the hyper-vigilant and maladaptive ways of responding to their children’s difficult behaviors with more mindful techniques. Responding more mindfully to their children could help caregivers focus more on the present and participate in life more fully and meaningfully.

Timeline of Procedures & Data Collected  Pre-Program:1. Obtained informed consent,

completed demographic, lifestyle & well-

being surveys2. Focus group: audio-taped & field

notes (FN) 3. Designed lifestyle program 4. Follow-up focus group: audio-

taped & FN 5. Program refinement & ipad app

developed6. Motivational Interviews: audio-

taped & FNMonth Program:Ongoing meetings, interviews, & e-mail correspondence with caregivers (Audio-taped & Field notes)Data AnalysisFocus groups & motivational interviews audio-tapes were transcribed verbatim & open-coded using HyperRESEARCH. Themes were developed, refined, and then verified by a second research team member.

Use of Mindful-Cognitive Micro-Strategies on the ipad App

The caregivers liked the variety of content, brevity, and layout of the mindful-cognitive micro-strategies on the ipad app. However, certain barriers limited use of the strategies, such as time restraints, slow internet connections, technology issues, & lack of knowledge on how to use technology.Barriers to MindfulnessCaregivers’ lack of time, constant problem-solving, and automatic vigilance were identified as barriers to being mindful in daily life.

“You don't leave that stuff (constant-problem solving) at home. It comes to work…It's there all the time…It never goes away,

and you're doing what you're doing but you're actually thinking about the IEP or what went wrong at breakfast.”

Desires for Mindfulness Caregivers reported the desire and need to be more mindful about themselves, their parenting strategies, and their family time. Also, they noted that mindfulness strategies would have been useful at the time of their child’s diagnosis of autism.

“Yeah, I think you do have to develop that strategy where you're subconsciously doing activities that take you out of your,

you know your regular life and into whatever you're doing.”

Road to MindfulnessCaregivers reported positive changes in attitude since the time of their child’s diagnosis. This optimism and attention to life are beginning elements of mindfulness that can be built upon.

“I think that things work out and you know you can work through that…things can still be awesome. It's just that maybe they don't

seem like it when you have the diagnosis and things are going crazy.”

1. Smith, L. E., Hong, J., Seltzer, M. M., Greenberg, J. S., Almeida, D. M., & Bishop, S. L. (2010). Daily experiences among mothers of adolescents and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 40(2), 167-178. doi:10.1007/s10803-009-0844-y

2. Hamilton, N. A., Kitzman, H., & Guyotte, S. (2006). Enhancing health and emotion: Mindfulness as a missing link between cognitive therapy and positive psychology. Journal of Cognitive Psychotherapy, 20(2), 123-134.

RESEARCH METHODS

FINDINGS CONCLUSIONSINTRODUCTION

IMPLICATIONS FOR PRACTICE

REFERENCES

RESULTS

EMERGENT THEMES

ACKNOWLEDGEMENTS