Extended Abstract

1. Introduction
Various studies in Iran conducted on the parents of children with Autism Spectrum Disorder (ASD) have shown that these parents have a higher degree of stress and mental health problems compared to the parents of children with no ASD [4-6]. The stress level that these parents experience are affected by the resources that are available to them [7, 8]. The parents participating in supportive group training experience less stress in the relationship with their ASD children and feel less social isolation [12]. 
The study by Ahmadi et al. (2011) on the needs of parents of children with ASD in Iran showed that these parents reported their most important needs as receiving guidance and information on the cause of problematic and abnormal behaviors in children and how to deal with these behaviors. They also emphasized on the need to spend time with friends and being supported by other members of the family [13]. Tonge et al. [21] studied the effect of a 20-week education program teaching behavioral management skills on the parents of children with ASD aged 2.5-5 years. Their results showed that the parents participating in this program had a higher improvement in mental health than the control group. The present study aimed to examine the effect a parental education program on the mental health of parents and behavioral problems of their children with ASD.
2. Methods
The study samples (n=30) were selected from among the parents of children with ASD referred to the clinic of Tehran Psychiatric Institute. All of these children were examined by a pediatric psychiatrist before entering the study and their ASD was diagnosed based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Inclusion criteria for participants were having at least one child with ASD at pre-school and school age, and not attending other courses of behavioral education for parents in the last 3 years. Before collecting data, the study purpose was explained to the subjects and written informed consent was obtained from all of them.
3. Results
Table 1 shows the demographic characteristics of children and their mothers. Regarding the type of study (interventional) and various problems of patients, the results were analyzed in two groups of 12 patients due to initial sample drop. The first post-test measurement was conducted one week after the intervention. General health was assessed before and after the intervention. The ANCOVA was used to analyze the effect of psychoeducational program. For one-way ANOVA, first the equality of covariance matrix was tested by Mauchly's test of sphericity. Since the significance level of the Mauchly's sphericity was greater than 0.05 (w=0.909, P<0.05), the homogeneity assumption of variances was supported and ANCOVA can be used. A summary of ANOVA results is presented in Table 2. Considering that the calculated F(4.958) is significant (P=-0.023), it can be said that there is a significant difference in general health, family functioning, child behavior, and coping strategies between two intervention and control groups.
Multivariate ANCOA results indicated the significant effect of psychoeducational program on the reduction of clinical symptoms. The findings showed that the F ratio obtained from the comparing the mean scores of clinical symptoms in the pretest and posttest phases was significant (F=321.991, P<0.05) (Table 3). Furthermore, results of Bonferroni post-hoc test showed that psychoeducational program in the post-test and follow-up phases had a significant effect on the reduction of clinical symptoms and the results remained constant during the 3-month follow-up phase (P<0.05).
4. Discussion and Conclusion
Studies conducted in Iran show that parents of children with ASD have a higher degree of stress and mental health problems compared to the parents of normal children [4-6]. They highly need to receive information about ASD and how to deal with it and gain social support [13, 14]. This program showed that having information about the disease can improve coping strategies, mental health, child behavior, and family functioning. By such training groups, parents can have time and space to discuss about their reactions to their children’s disease, their emotions and the impact of this disease on them and their family members. The results of present study indicated the effect of parental group training in the field of ASD and its management skills on the mental health of parents. This training can provide an opportunity for the parents’ participation in the groups and receiving information for dealing with their ASD children’s behaviors.
Ethical Considerations
Compliance with ethical guidelines
All ethical principles were considered in this article. The participants were informed about the purpose of the research and its implementation stages; they were also assured about the confidentiality of their information; Moreover, They were allowed to leave the study whenever they wish, and if desired, the results of the research would be available to them.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contributions
Conceptualization and Methodology: Mitra Hakim shooshtari; Editing and Review: Jamileh Zareee; Writing and Data analysis: Hadi Zarafshan, Mehrdad Mohamadian, Isa Karimi Keisomi, Hooshangi Helia.
Conflicts of interest
The authors declared no conflict of interest.

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