Background & Objectives: Autism spectrum disorder is one of the disorders related to people's brain development. At first, attention is paid to its effects on how a person communicates with society and the emergence of his/her unique and repetitive behaviors. People with autism spectrum disorder are more likely to have social problems. Children with autism spectrum disorder experience many crises that cause internalizing or externalizing behaviors. The behavior of these children is often repetitive, harmful, aggressive, and unnatural. Having a child with autism spectrum disorder is considered a challenging experience for parents and affects the foundation of the family in an all-around way. Since autism spectrum disorder causes behavioral problems, it seems necessary to implement training and intervention programs to improve people's problems. Therefore, the present study aims to determine the effectiveness of behavior management training for mothers on internalizing and externalizing behavioral problems of children with an autism spectrum disorder.
Methods: The research method was quasi-experimental with a pretest–posttest design with a control group. The study's statistical population comprised all mothers with a child with high–functioning autism who were referred to the comprehensive health rehabilitation center in Tehran City, Iran in the spring and summer of 2019. Thirty qualified volunteers were included in the study using the available sampling method. Then, 15 people were randomly assigned to the experimental group and 15 to the control group. The inclusion criteria were as follows: having a child with high-functioning autism diagnosed by a resident psychiatrist at Avand Health Rehabilitation Center, having minimum reading and writing literacy to complete the questionnaires, not participating in other treatment programs at the same time, and not receiving individual counselling or drug therapy. The exclusion criteria were as follows: absence of more than two sessions from the intervention and dissatisfaction with meeting participation. The research tools included Child Behavior Checklist (CBCL) (Achenbach, 1991) and Autism Spectrum Screening Questionnaire (Ehler et al. 1993). The behavior management training intervention was conducted for two months in 8 weekly sessions, each lasting 2 hours for the experimental group. To describe and analyze the data, descriptive statistics (mean and standard deviation) and inferential statistics (univariate covariance analysis and t test to compare the averages of two independent groups) were used in SPSS version 24 at a significance level of 0.05.
Results: The results showed that after removing the effect of the pretest, there were significant differences between the experimental and control groups regarding the average scores of internalizing behaviors, including anxiety/depression (p<0.001), withdrawal/depression (p<0.001), physical complaints (p<0.001); externalizing behaviors, including law-breaking behaviors (p<0.001), aggressive behaviors (p<0.001); and other behavioral problems, including social problems (p<0.001), thinking problems (p<0.001), and attention problems (p<0.001) in the posttest.
Conclusion: Based on the findings of this study, behavior management training for mothers with children with high-functioning autism can be used to improve the internalizing and externalizing problem behaviors in these children.