Reducing Parental Accommodation in Neurodiverse Families: Adaptation of a Digital Single-Session Intervention.

Abstract

Families of children with neurodevelopmental disorders often face limited access to evidence-based mental health care and supports, despite a disproportionately high prevalence of co-occurring conditions, such as anxiety, among these children. This study aimed to adapt a digital single-session intervention (SSI) designed to reduce parental accommodation of child anxiety by incorporating direct feedback from parents of neurodiverse children. In December 2024, five online human-centered design workshops were conducted with six parents, who provided input on the intervention's content (e.g., clarity, relevance) and acceptability (e.g., language, confidence to make a change). Responses were systematically coded and analyzed using content analysis. Across workshops, parents emphasized the need for interventions to be practically relevant, emotionally validating, and reflective of daily caregiving experiences, where "every day can feel like a wrestling match." Participants also raised concerns about the term "accommodation," which carries a positive connotation within the disability communities. Based on this feedback, revisions included incorporating neurodiversity-specific examples and parenting strategies and using descriptions of rather than labeling parenting behaviors. Through lived experiences, caregiver feedback revealed important adaptations needed to enhance intervention effectiveness and acceptability. Co-designing SSIs with families has the potential to promote equitable access to evidence-based mental health care, and successful adaptations present a scalable framework for integrating SSIs into child mental health services across settings.