Psycho-educational Program to Enhance Alerting Consciousness and Seeking Support Among Family Caregivers Having Children With Autism

1. Introduction and Rationale According to the World Health Organization (WHO), the prevalence of ASD worldwide is 1 in every 100 children. The prevalence of ASD in Egypt is estimated at 5.4/1000 among Egyptian children. Children with ASD impose distinct challenges on their family caregivers due to being unable to cope effectively, including financial, physical, and psychological challenges, which can lead to significant stress, burden, and pessimism. So, it's important for a psychoeducational program to support caregivers who have children with ASD to deal with their psychological problems as well as find alerting consciousness and seek support that increases their life satisfaction and quality of life that enables caregivers to deal with their children suffering.

   Caregivers can employ both sorts of coping strategies concurrently, and their efficacy can impact the overall welfare of the family. These include seeking guidance and assistance from healthcare professionals and support groups, establishing regular routines and structures in daily life, and engaging in mindfulness and relaxation techniques. In addition, certain caregivers may employ alerting consciousness. It is crucial to acknowledge that the efficacy of coping methods might differ among parents, and the selection of coping strategy may be influenced by the individual's personal traits, the intensity of the child's symptoms, and the presence of social support.

   This study aimed to evaluate the effect of a psycho-educational program to enhance alert consciousness and seeking support among family caregivers having children with autism.

2. Study Objectives and Hypothesis

   Primary Aim: evaluate the effect of a psycho-educational program to enhance alert consciousness and seeking support among family caregivers having children with autism.

   Primary Hypothesis: A psycho-educational program will have a positive effect after implementation on enhancing alerting consciousness and seeking support among family caregivers having children with autism.

3. Methods 3.1. Study Design: A quasi-experimental, one-group pre-test/post-test design was employed.

3.2. Setting: at an autistic center affiliated to El-Abbasia psychiatric and mental Hospital in Cairo, Egypt.

3.3. Participants: A purposive sample of family caregivers of children with autism registered in the previously mentioned setting was recruited. Inclusion criteria were related to the child: Age from 6 to 12 years old (school age) and No neurological or physical disorders or disability. Also, regarding to family caregivers: Be the primary caregiver at the same home and provide direct care for the children at least 1 year, and don't have other children with special needs or disabilities.

Sample size was determined via power analysis (α=0.05, β=0.15) based on a previous study.

3.4. Intervention (a psycho-educational program): The researcher-developed program, reviewed by supervisors and grounded in literature, comprised 11 core sessions (4 theoretical, 7 practical) plus orientation and closure sessions, delivered over 45 to 60 minutes each.

Theoretical Component (Sessions 1-4): Covered autism, management plans, challenges confronting family caregivers

Practical Component (Sessions 5-11): Focused on applied across three domains:

Optimism (Sessions 5): Optimism, definitions, concepts, and strategies for enhancement

Coping patterns (Sessions 6-11): Stress management, meditation, problem solving, relaxation techniques, and mindfulness.

Pedagogy: Interactive methods were used, including open discussions, brainstorming, role-playing, demonstrations, videos, and handouts. Each session included homework review, feedback, objective setting, and a Q&A period.

3.5. Data Collection Tools:

Tool I: Interview Questionnaire Collected socio-demographic and clinical data For the child: age in years, gender, number of siblings, child order, and level of education.

For family caregivers: Age, gender, marital status, level of education, degree of contingency, occupation, residence, and income.

Tool II: Clinical data tool: : assesses clinical data for children with autism such as enrollment in the behavioral modification program and onset of diagnosis. And family history of psychiatric or mental illness.

Tool III: Brief-COPE inventoryIt was used to assess alerting consciousness and seeking support among family caregivers of children with ASD. It consists of 28 items presented in the form of a coping statement, and the responses ranged from: I have not been doing this at all (1), to I have been doing this a lot (4). scoring system: ;The alerting consciousness and seeking support of the caregivers of children with autism were considered ineffective if the score was < 50% and effective if the percent score was ≥ 50%.Demonstrated high reliability in this study (Cronbach's α = 0.968).

3.6. Data Collection Procedure: The 6-month study (Feb-June 2025) followed stages: ethical approvals, baseline (pre-test) data collection using Tools I and II, program implementation n=50 post-test) 3.7. Statistical Analysis: Data were analyzed using SPSS v26. Descriptive statistics (frequencies, percentages, means, standard deviations) described the sample. A paired t-test was used to compare pre- and post-intervention self-efficacy scores, with a significance level of p < 0.05.

Ethics: Approved by the Faculty of Nursing, Ain Shams University IRB (ID: 26.041229). Informed consent was obtained from all participants