Strengths and limitations
autistic, autism
This study had many strengths. This was one of only two RCTs testing the efficacy of ACT for improving well-being in parents of autistic children, allowing us to elucidate the treatment effects of ACT while controlling for time and repeated measurements. In addition, the inclusion of a follow-up assessment ensures that longer-term program effects are captured. The heterogeneity of the sample, in terms of including fathers, as well as parents of autistic children spanning a range of ages, socio-communication functioning, and adaptive skills, is also a strength, and improves generalizability of findings to more parents of autistic people.There are also key limitations to our study. Participants were recruited mainly through autism service agencies, and many were already receiving supports and services for their child, which may limit generalization to families who do not have any support, or who are unwilling to potentially wait 4 months to receive the program. Twenty-two Treatment group participants completed the main intervention weekend, and four were unable to attend the refresher one month later, leaving only 18 full “treatment completers.” In addition, all outcomes were assessed through subjective parent report, which could potentially influence the validity of results or limit some effects of the intervention being captured. Further, the high average level of household income and parent education, limited racial/ethnic diversity, and relatively low levels of parent mental health problems in this cohort limit the conclusions that can be drawn regarding the effect of ACT for parents with less education, with varying cultural backgrounds, or with greater need.