Parenting Stress in Mothers and Fathers of Toddlers with Autism Spectrum Disorders: Associations with Child Characteristics

Elevated parenting stress is observed among mothers of older children with autism spectrum disorders (ASD), but little is known about parents of young newly-diagnosed children. Associations between child behavior and parenting stress were examined in mothers and fathers of 54 toddlers with ASD (mean age = 26.9 months). Parents reported elevated parenting stress. Deficits/delays in children's social relatedness were associated with overall parenting stress, parent-child relationship problems, and distress for mothers and fathers. Regulatory problems were associated with maternal stress, whereas externalizing behaviors were associated with paternal stress. Cognitive functioning, communication deficits, and atypical behaviors were not uniquely associated with parenting stress. Clinical assessment of parental stress, acknowledging differences in parenting experiences for mothers and fathers of young children with ASD, is needed.     

The Association Between Mental Health, Stress, and Coping Supports in Mothers of Children with Autism Spectrum Disorders

Raising a child with an autism spectrum disorder (ASD) can be a stressful experience for parents. When left unmanaged, high stress levels can lead to the development of depressive symptomatology, highlighting the importance of coping supports. The current paper examined the stress level and psychological wellbeing of mothers with a child with ASD in a national survey. After adjusting for child, mother and family level characteristics, it was determined that mothers of children with ASDs were at greater risk for poor mental health and high stress levels compared to mothers of children without ASDs. The presence of maternal coping strategies, in the form of emotional and neighborhood social supports, as well as strong coping skills, reduced these risks between models.     

Parenting stress within mother-father dyads raising a young child with autism spectrum disorder

BackgroundThe present study assessed different facets of parenting stress in families with a child with ASD (perceptions of parenting-related roles, parent-child interactions, and the child’s behaviors) at three timepoints: right after receiving an ASD diagnosis, immediately following specialized intervention services, and one year after receiving services, upon primary school entry.MethodParticipants were 258 mother-father dyads and their child. Parents provided demographic information and completed measures on their parenting stress and their child’s autism symptom severity.ResultsPartial correlations revealed that, at the time of diagnosis, after controlling for children’s age and autism symptom severity, mothers’ and fathers’ stress was positively and significantly associated with each other, suggesting a bidirectional relation between partners’ psychological adjustment. Cross-lagged panel analyses demonstrated different longitudinal and transactional links, depending on the dimension of stress examined.ConclusionsFindings are discussed in terms of supports that could assist mothers and fathers of children with ASD.     

Factors associated with depressive symptoms in parents of children with autism spectrum disorders

Parents of children with autism spectrum disorders (ASDs) have higher rates of depressive symptoms than parents of typically developing (TD) children or parents of children with other developmental disorders. The purpose of this study was to examine child and parent sleep as factors associated with depressive symptoms in parents of children with ASDs. Participants included 34 families (17 ASD, 17 TD, 17 mothers and 11 fathers per group). Both objective sleep quantity (actigraphy) and subjective sleep quality were obtained, along with measures of parent depressive symptoms and child daytime behavior. Child sleep quantity was a significant predictor of maternal depressive symptoms, controlling for group and child behavior. Fathers sleep quality was a significant predictor of paternal depressive symptoms, controlling for child behavior and child sleep disturbances. This study suggests that along with child behavior, parent and child sleep variables are associated with parental depressive symptoms. Future studies should continue to use a multi-method measurement approach for sleep, and interventions that target child sleep should include parent sleep and parent daytime functioning as outcome variables.     

Psychological well-being in parents of children with Angelman, Cornelia de Lange and Cri du Chat syndromes

Background The current study focuses on mothers and fathers of children with three rare genetic syndromes that are relatively unexplored in terms of family experience: Angelman syndrome, Cornelia de Lange syndrome and Cri du Chat syndrome. Method Parents of children with Angelman syndrome (n = 15), Cornelia de Lange syndrome (n = 16) and Cri du Chat syndrome (n = 18), and a matched comparison group of parents of children with autism and intellectual disabilities (n = 20) completed questionnaires on both psychological distress (stress, anxiety, depression) and positive psychological functioning. Results Parents of children with Angelman syndrome consistently reported the highest levels of psychological distress, and parents of children with Cornelia de Lange syndrome the lowest, with parents of children with Cri du Chat syndrome and autism scoring between these two. Positive psychological functioning was similar across the four aetiology groups. Conclusions Parents of children with rare genetic syndromes are at risk for high levels of stress and mental health problems. Methodological issues and the practical applications of these results are discussed.     

Maternal Parenting Behavior and Child Behavior Problems in Families of Children and Adolescents with Autism Spectrum Disorder

Parents of a child with autism spectrum disorder (ASD) face specific challenges in parenting, but concrete parenting behavior has never been properly investigated in these families. This exploratory questionnaire study compared parenting behaviors among mothers of children and adolescents with ASD (n = 552) and without ASD (n = 437) and examined associations between child behavior problems and parenting behavior. Results showed that mothers of children with ASD reported significantly lower scores on Rules and Discipline and higher scores on Positive Parenting, Stimulating the Development, and Adapting the Environment. Age was differently related to parenting behavior in the ASD versus control group. Furthermore, distinctive correlation patterns between parenting behavior and externalizing or internalizing behavior problems were found for both groups.     

Mothers’ perceived physical health during early and middle childhood: Relations with child developmental delay and behavior problems

The self-perceived physical health of mothers raising children with developmental delay (DD; N = 116) or typical development (TD; N = 129) was examined across child ages 3–9 years, revealing three main findings. First, mothers of children with DD experienced poorer self-rated physical health than mothers of children with TD at each age. Latent growth curve analyses indicated that mothers in the DD group experienced poorer health from age 3 but that the two groups showed similar growth across ages 3–9 years. Second, cross-lagged panel analyses supported a child-driven pathway in early childhood (ages 3–5) by which early mother-reported child behavior problems predicted poorer maternal health over time, while the reversed, health-driven path was not supported. Third, this cross-lagged path was significantly stronger in the DD group, indicating that behavior problems more strongly impact mothers’ health when children have developmental delay than when children have typical development. The health disparity between mothers of children with DD vs. TD stabilized by child age 5 and persisted across early and middle childhood. Early interventions ought to focus on mothers’ well-being, both psychological and physical, in addition to child functioning.     

Stress in mothers of children with autism: Trait mindfulness as a protective factor

Mindfulness-based interventions may reduce parents’ stress and improve parent–child relationships. Given the chronic nature of autism spectrum disorder (ASD) and its influence on parents’ stress, interventions to promote mindfulness may be especially helpful for parents of children with ASD. Prior to undertaking intervention development, it is first necessary to establish the relationship between mindfulness and stress, as other factors like child behavioral difficulties may overshadow the mother's regulation strategies. In a sample of mothers of children with ASD (n = 67) and a comparison sample of mothers without ASD (n = 87), mindfulness was significantly associated with the level of maternal stress above and beyond child behavior problems (non-ASD: β = −.232; F(1, 64) = 15.749, p < .000; ASD: β = −.206; F(1, 84) = 15.576, p < .000). Results suggest that interventions to promote mindfulness may be helpful in reducing parenting stress among mothers of children with ASD, as well as mothers of typically developing children. Due to the chronic nature of ASD, such interventions may be particularly applicable.     

Multilevel approach to gender differences in adaptation in father-mother dyads parenting individuals with Autism Spectrum Disorder

BackgroundMost studies of gender differences in the ASD literature present methodological limitations regarding the treatment of dyadic data. This work explored gender differences in the psychological adaptation of a sample of Spanish fathers and mothers of individuals with Autism Spectrum Disorder (ASD) using a multilevel modeling approach (MLM) that accounts for nested data.MethodQuestionnaires including different adaptation measures were completed by 120 father-mother dyads raising individuals with ASD. We designed a two-level model (parents nested in dyads) with three predictor variables at level 1 (parent gender, parent age, and perception of child’s behavior problems) and four predictor variables at level 2 (child age, family income, ASD severity, and time since diagnosis) to examine the influence of these variables on negative and positive psychological outcomes (stress, anxiety, depression, and psychological well-being).ResultsMothers experienced higher levels of stress and anxiety than fathers, even after controlling for interdependence and sociodemographic factors. ASD severity was a significant predictor of both progenitors’ stress and well-being, and family income was also related to psychological well-being, although no gender differences were observed in the way these variables are related to parental outcomes.ConclusionsProfessionals should offer parents support to adjust expectations according to their child’s ASD severity given its relationship to parental stress and well-being. Considering that mothers experience higher levels of stress and anxiety than fathers, clinicians should encourage maternal protective factors. Finally, governments should consider new policies aiming to support ASD families’ treatment expenses.     

Parental stress among parents of toddlers with moderate hearing loss

BackgroundThe purpose of this study was to examine parental stress in parents of toddlers with moderate hearing loss compared to hearing controls. Furthermore, the associations between parental stress and child- and parent-related factors such as language, social-emotional functioning and social support were examined.DesignThe study sample consisted of 30 toddlers with moderate hearing loss and 30 hearing children (mean age 27.4 months). The two groups were compared using the Nijmegen Parenting Stress Index (NPSI) and parent-reports to rate the amount of social support and the children’s social-emotional functioning. Receptive and expressive language tests were administered to the children to examine their language ability.ResultsParents of toddlers with moderate hearing loss reported comparable levels of parental stress to parents of hearing children. Individual differences in parental stress were related to child- and parent-related factors. Poorer social-emotional functioning and language ability of the child were related to higher stress levels in parents. Parents who experienced less social support reported higher stress levels.ConclusionsParents of toddlers with moderate hearing loss experience no more parental stress than parents of hearing children on average. Given parental stress was found to be related to poorer child functioning, early interventionists should be aware of signs of elevated stress levels in parents.     

Language abilities in monolingual- and bilingual- exposed children with autism or other developmental disorders

BackgroundParents and providers are sometimes concerned that exposure to two languages will impair language acquisition in children with autism spectrum disorder (ASD) or other developmental disorders (DD). However, research to date suggests that language milestones and abilities are unaffected by this exposure. The current study explored language abilities in toddlers with ASD or DD exposed to one versus multiple languages, prior to intervention. To our knowledge, this is the largest investigation of language learning in bilingual-exposed (BE) children with ASD.MethodsParticipants were 388 children evaluated as part of a larger study on the early detection of ASD. Parents were asked to list all languages that primary caretakers use to communicate with their child. One hundred six BE children (57 ASD, 49 DD) were compared to 282 monolingual-exposed (ME) children (176 ASD, 106 DD). The Mullen Scales of Early Learning assessed nonverbal and verbal abilities. Multiple regression was used to evaluate the relationship of BE to language abilities, beyond the influence of nonverbal cognitive abilities, diagnosis, and socioeconomic status.ResultsResults showed greater language impairment in ASD than DD, but no main effect for language exposure group nor any interaction of language group by diagnosis. Results remained consistent after controlling for socioeconomic status.ConclusionThis study suggests that bilingual caregivers can communicate with their children in both languages without adverse effects on their children’s language functioning.     

Long-term psychological distress in parents of child survivors of severe meningococcal disease

Objective: To study psychological distress in parents of child survivors of Severe Meningococcal Disease (SMD) after discharge of their child from the Paediatric Intensive Care Unit (PICU).

Methods: This study approached parents of child survivors of SMD treated on the PICU between 1993–2001. Five cross-sectional groups were created for mothers and fathers separately. The five groups differed from each other by the period after discharge they entered the project (ranging from 3 months to 7 years after discharge). For research purposes, mothers and fathers (n =?192) individually completed the Goldberg General Health Questionnaire-30 (GHQ), measuring their level of psychological distress.

Statistics: Mean group scores were examined and a one-way-analysis of variance (ANOVA) performed to study differences between groups for mothers and fathers separately. In addition, percentages of parents with GHQ scores above cut-off were calculated and it was determined whether it differed from norm data.

Results: Data reveal that both mothers and fathers experience high mean levels of psychological distress after discharge, showing no significant differences in group means over time. High percentages of parents experience psychological distress after discharge, if compared with the normal population.

Conclusions: Parents of child survivors of SMD experience profound and prolonged psychological distress after discharge. Future interventions should focus on follow-up care for this population to help them re-adjust after this stressful event.     

Contributors to well-being and stress in parents of children with autism spectrum disorder

BackgroundParents of children with autism spectrum disorder (ASD) present more well-being and stress problems than parents of typically developing (TD) children. However not all parents present these problems. These problems can be due to a dynamic interaction between environmental antecedents, person antecedents, and mediating processes. Understanding how these factors separately contribute to explain parents’ well-being and stress can have implications for intervention programs. The aim of this study was to explain parents’ subjective well-being and physiological stress by considering whether they had a child with ASD or not and their child’s negativity (environmental antecedents), their perception of their child’s problems (person antecedents), and their use of reappraisal (mediating processes).MethodThirty-seven parents of children with ASD and 41 parents of TD children reported their subjective well-being and their physiological stress was assessed. Additionally, children’s negativity was observed, parents rated their perception of their child’s problems (autistic traits, emotion regulation ability, and lability/negativity), and parents reported their use of reappraisal.ResultsCompared to parents of TD children, parents of children with ASD reported having lower subjective well-being and had increased physiological stress. Parents’ perceptions of children’s lability/negativity and parents’ use of reappraisal were better predictors of parents’ subjective well-being than ASD and parents’ perceptions of children’s lability/negativity contributed to parents’ physiological stress as much as ASD.ConclusionsPrevention and intervention programs targeting parental well-being and stress will benefit from working with parents at the level of perceptual constructs and reappraisal ability.     

Death concerns and psychological well-being in mothers of children with autism spectrum disorder

PurposeUtilizing a terror management theory perspective, the present research examined whether having a child with autism spectrum disorder (ASD) is associated with underlying cognitions and explicit worries about death, and their roles in psychological well-being.Method147 mothers of children with ASD (n = 74) and typically developing children (n = 73) completed a fear of death scale, as well as measures of death-thought accessibility, positive and negative affect, depression, and anxiety.ResultsFollowing previous research, mothers of children with ASD reported worse psychological health. Additionally, they evidenced greater death-thought accessibility compared to mothers of typically developing children, but did not differ in explicit worries about mortality. Greater death-thought accessibility, in turn, mediated the influence of ASD diagnosis on negative affect, depression, and anxiety.ConclusionThe current study offers an initial understanding of the association between mortality concerns and psychological health for mothers of children with ASD. Further, it underscores the importance of health care providers’ efforts to attend to, and educate parents about, their thoughts of mortality, even if the parent does not acknowledge such concerns.What this paper addsThe present study examined the impact of both implicit and explicit worries about death in parents of children with Autism Spectrum Disorder (ASD). Specifically, we were able to demonstrate that increased death-thought accessibility among mothers of children with ASD was associated with worse psychological health. While it is possible for parents of children with ASD to report conscious worries about death, there were no observed differences on this measure. As far as we know, this work is the first to empirically examine the prevalence of mortality-related concerns in this population and the subsequent effects of death-thought accessibility on psychological health. This is an important avenue of research as parents of children with ASD may experience greater worries about leaving their children upon death with no one to care for them, or to leave their children in the care of individuals who may not understand their son or daughter's unique needs. Additionally, the current findings highlight the importance of addressing mortality-related concerns, even when they may not be explicitly recognized, among parents of children with ASD. Given the effectiveness of parent education programs for children with ASD, a primary avenue for intervention may be education. Training care providers in ways to better discuss thoughts of death may help to alleviate stress and foster greater psychological well-being.     

Évaluation d’un programme francophone de formation aux habiletés parentales dans le cadre des troubles du spectre de l’autisme auprès d’un groupe pilote

Objectives

Autism spectrum disorders (ASD) are not only affecting the development of the child diagnosed with this disorder, but also their entire family. Parents of children with ASD face many challenges that affect their well-being and family's quality of life. These parents need support to understand their child's diagnosis, to face maladaptive behaviors and to promote skill acquisition. Parent training programs (PT) are known to increase parents’ knowledge and skills in these areas. The potential benefits for the families are reduced stress for parents, improvements in the child's development and better parent–child interactions. Unfortunately, a few structured PTs are available to French-speaking families with an ASD child. In order to provide them with this type of intervention, we developed a French parent training named “L’A.B.C. du comportement de l’enfant ayant un TED/TSA: Des parents en action!” and based on applied behavior analysis. The application and evaluation of this new intervention technique follow the recommendations for research studies on psychosocial interventions for individuals with ASD. Therefore, an initial efficacy study has been conducted to establish the promise of this PT. This paper presents the results of the first group of parents.

The predictors of distress in parents of children with autism spectrum disorder

Abstract

Background It is well recognised that parents of children with autism spectrum disorder (ASD) often experience clinically significant levels of stress and depression. This study examined which ASD characteristic best predicted parental distress.

Method Parents of 109 children aged between 4 and 12 (M age = 7.89, SD = 2.43) completed self-report measures of anxiety, depression, stress, and parenting-specific stress. They also completed rating scales regarding their child's ASD characteristics.

Results This study found that the child's behavioural and emotional impairments predicted the parents’ overall levels of distress (i.e., stress/tension, anxiety, and depression), but not the stress associated with parenting. Instead, the child's social impairment severity was found to predict parenting-specific stress.

Conclusion This study highlights the pervasive influence of ASD symptomatology on the mental wellbeing of the parents and the importance of assisting parents to cope with the behavioural and social impairments of their child.     

The Association Between Child Autism Symptomatology, Maternal Quality of Life, and Risk for Depression

Parents raising children with autism spectrum disorders (ASDs) have been shown to experience high levels of stress and report a lower quality of life. The current study examined the association between child autism symptomatology, mother’s quality of life, and mother’s risk for depression in a sample of 1,110 mothers recruited from a web-based registry of families with children with an ASD. Higher autism symptomatology and a greater number of co-occurring psychiatric disorders in the child were associated with an increased risk for current treatment of maternal depression and a lower maternal quality of life. The results highlight the importance of screening for depression, particularly in mothers of children with ASD and mental health and behavioral challenges.     

Parenting stress and child behavior problems within families of children with developmental disabilities: Transactional relations across 15 years

Parents of children with developmental disabilities (DD) are at increased risk of experiencing psychological stress compared to other parents. Children's high levels of internalizing and externalizing problems have been found to contribute to this elevated level of stress. Few studies have considered the reverse direction of effects, however, in families where a child has a DD. The present study investigated transactional relations between child behavior problems and maternal stress within 176 families raising a child with early diagnosed DD. There was evidence of both child-driven and parent-driven effects over the 15-year study period, spanning from early childhood (age 3) to adolescence (age 18), consistent with transactional models of development. Parent–child transactions were found to vary across different life phases and with different domains of behavior problems.     

Quality of life for parents of children with autism spectrum disorders

This project describes health-related quality of life (HRQoL) of parents of children with autism spectrum disorders (ASDs) using mixed methods. Parents of children with ASDs (N = 224) reported on their HRQoL, depression, and caregiving burden using quantitative tools. HRQoL scores were slightly worse than from those in normative populations especially related to stress and mental health. For example, parents reported average HRQoL scores from SF-6D of 0.74, which was clinically significant lower than an average normative U.S. population. 40% of parents reported having clinical depression symptoms. Married parents reported lower depression symptoms than parents who were not. In addition, families with three or more children with special health care needs (CSHCN) reported lower HRQL and higher caregiving burden than families with less CSHCN. In the qualitative study, we conducted five focus groups to gain insight as to the reasons a child's ASD might influence a parent's HRQoL. Qualitative data further supports the notion that parental HRQoL was negatively influenced by their child's ASDs. Studies that seek to quantify the influence of ASDs and to assess the effect of interventions for children with ASDs may consider measuring the effects on family members as well.