Developmental and behavior problems predict parenting stress in young children with global delay

To identify parent-reported symptoms that predict parenting stress in preschoolers with global developmental delay, 201 parents/guardians of 142 boys and 59 girls with global delay, mean age 39.1 months (range, 18 to 63 months) were studied retrospectively. Parents completed the following: (a) a semistructured interview; (b) the Child Development Inventory, (c) Child Behavior Checklist 1½-5, and the (d) Parenting Stress Index-Short Form. Forty-two percent of parents described clinically significant parenting stress (≥ 85th percentile). The Parenting Stress Index-Short Form subscales Difficult Child and Parent-Child Dysfunctional Interactions were elevated. Parental stress increased with higher gross motor development and decreased as social and fine-motor ratios increased. Furthermore, stress increased when parents reported higher levels on the Emotionally Reactive and Withdrawn scale scores and when parents reported Pervasive Developmental and Oppositional Defiant Problems. In mobile children with global delay, behavior problems predict parenting stress.     

Parenting stress in mothers of children with an intellectual disability: the effects of parental cognitions in relation to child characteristics and family support

Background Recent theories of stress and coping in parents of children with intellectual disabilities (ID) emphasize the importance of cognitive appraisals in influencing parents’ levels of stress and their adaptations to difficulties presented by the children. This study investigated the relationships between parental cognitions, child characteristics, family support and parenting stress. The aspects of cognitions studied were: parenting self-esteem (including efficacy and satisfaction) and parental locus of control. Methods The group studied consisted of 46 mothers of children with ID. The Vineland Adaptive Behavior Scales and Maladaptive Behavior Domain were administered by interview. Mothers also completed four questionnaires: the Family Support Scale, the Parenting Sense of Competence Scale, a shortened form of the Parental Locus of Control Scale and the Parenting Stress Index (Short Form). Results Data were analysed using Pearson's correlation coefficients, partial correlations and a regression analysis. The results indicated that most of the variance in parenting stress was explained by parental locus of control, parenting satisfaction and child behaviour difficulties. Whilst there was also a strong correlation between family support and parenting stress, this was mediated by parental locus of control. Conclusions The results demonstrate the potential importance of parental cognitions in influencing parental stress levels. It is argued that these results have implications for clinical interventions for promoting parents’ coping strategies in managing children with ID and behavioural difficulties.     

Parenting stress in mothers of adults with an intellectual disability: parental cognitions in relation to child characteristics and family support

Background There is a body of evidence that indicates that the cognitions of parents of children with intellectual disabilities (ID) play an important role in influencing parental stress. However, there is a paucity of evidence about the experience of parents of adult children with ID. This study sought to apply a model of parenting stress to mothers of adults with ID. Of particular interest were the parental cognitions of parenting self‐esteem and parental locus of control. Method Face‐to face interviews were administered with 44 mothers of adults with ID. They completed the Vineland Adaptive and Maladaptive Behaviour Scale, the Family Support Scale, the Parenting Sense of Competence Scale, a shortened version of the Parental Locus of Control Scale and the Parenting Stress Index. Results Correlations were observed between parenting stress and the other study variables. Regression analysis revealed that parental cognitive variables predicted 61% of the variance in parenting stress. Parenting satisfaction, a subscale of the measure of parenting sense of competence, mediated the relationships between adaptive behaviour and parenting stress and between family support and parenting stress. Conclusions These results indicate the importance of cognitive variables in the stress of mothers of adults with ID. Potential avenues of future research might focus on the experience of fathers and the impact of positive perceptions as a cognitive factor.     

Parental Depression and Child Behavior Problems: A Pilot Study Examining Pathways of Influence

Parents of children with autism spectrum disorders (ASD) have higher rates of depressive symptoms than parents of typically developing children and parents of children with other developmental disorders. Parental depressive symptoms are strongly associated with problem behaviors in children; however, the mechanisms through which parental depression influences child behavior in families of children with ASD are unclear. The purpose of this study was to examine the relationship between parental depression and child behavior problems among families of children with ASD, more specifically to investigate the mediating variables that may explain the processes through which parental depression and child behavior problems are associated. The sample consisted of 33 parents of children with ASD (ages 2 to 5 years old). Findings suggested that authoritative parenting style significantly mediated the relationship between parental depression and behavior problems. This study highlights the importance of considering parental mental health and its impact on parenting behavior in interventions targeting child behavior problems.     

Parenting stress in parents of children with epilepsy and asthma

The purposes of this study were to identify differences in parenting stress between 2 samples and examine the factors associated with parenting stress. An asthma sample was selected to contrast with the epilepsy sample because both medical conditions are chronic episodic conditions that require daily medication. Data from 49 parents of epileptic children and 54 parents of asthmatic children were examined in this study. Samples were conducted in a hospital pediatric clinic. Parental stress was measured using Abidin's Parenting Stress Index-long form. There were 2 major domains in the Parenting Stress Index: parent domain and child domain. The parent domain included 7 subscales, and the child domain included 6 subscales. Overall, results showed that parental stress was higher in the epilepsy group. Significant differences were found in 7 subscales: adaptability, demanding, hyperactivity/distractibility, role restrictions, depression, relationship to spouse, and parental health. Possible explanations for a higher level of parenting stress in the epilepsy group were discrimination, poor child adaptation, the threat of unpredictability of the seizures, and neurological dysfunction. The causes of higher levels of parenting stress in the asthma group were limitation of activities and parental health condition. These differences should be considered when psychosocial care is offered. Results also showed that demographic variables (gender, age, and family social economic status), age at onset, and condition severity were not effective predictors for parenting stress.     

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.     

Parenting stress in families with very low birth weight preterm infants in early infancy

Taking care of a premature infant adds an extra burden to already stressed parents. Previous studies have shown that parental stress occurs during the initial hospitalization. However, there is little information on parental stress over time, and the few existing results are conflicting. In addition, many studies have focused on maternal stress but there is little information about a father's long-term adaptation to stress. The purpose of this study was to examine the degree and type of parenting stress in the families of very low birth weight (VLBW) preterm infants over the first two years of life. We compared parenting stress in families with preterm infants with control families, while also comparing the stress in mothers to that in fathers. Furthermore, we explored the relationship between parenting stress in the preterm group with identified factors that included the infant's age, medical complications, and parents’ perceived feeding issues after they had been discharged from the hospital. This was an exploratory study with a cross sectional design. Participants included a total of 505 mothers from Tainan, Taiwan; 297 with preterm children (239 mothers, 58 fathers) and 208 with full-term children (181 mothers, 27 fathers). Assessments including the Parenting Stress Index, Neonatal Medical Index and Behavior-based Feeding Questionnaire were used to measure parental distress, infants’ medical complications and parents’ perceived feeding issues, respectively. Results of the study, though not statistically significant, indicated the presence of increased parenting stress in parents of preterm infants as compared to parents of full-term infants. 13.1% of mothers with preterm infants demonstrated total stress levels that warranted clinical intervention. We also found that mothers of preterm infants presented different parenting stress patterns than fathers of preterm infants. Fathers of preterm infants tended to have overall higher stress scores than mothers. On the other hand, mothers of preterm infants tended to report more health related difficulties, more depression, higher social isolation and role restriction, and less support from their spouses, than reported by fathers. Moreover, as time went on, parents with preterm infants continued to experience greater parenting stress than those with full-term infants. Understanding the experiences of parents with preterm children is important for health care providers while interviewing parents for information regarding their children and designing intervention programs to improve children's outcomes.     

Are parental autism spectrum disorder and/or attention-deficit/Hyperactivity disorder symptoms related to parenting styles in families with ASD (+ADHD) affected children?

An understudied and sensitive topic nowadays is that even subthreshold symptoms of autism spectrum disorder (ASD) and attention-deficit/Hyperactivity disorder (ADHD) in parents may relate to their parenting styles. The aim of this study was to explore the influence of (the combined) effect of child diagnosis (ASD or ASD + ADHD affected/unaffected children) and parental ASD and/or ADHD on parenting styles. Ninety-six families were recruited with one child with a clinical ASD (+ADHD) diagnosis, and one unaffected sibling. Parental ASD and ADHD symptoms were assessed using self-report. The Parenting Styles Dimensions Questionnaire (PSDQ) self- and spouse-report were used to measure the authoritative, authoritarian, and permissive parenting styles. Fathers and mothers scored significantly higher than the norm data of the PSDQ on the permissive style regarding affected children, and lower on the authoritative and authoritarian parenting style for affected and unaffected children. Self- and spouse-report correlated modestly too strongly. Higher levels of paternal (not maternal) ADHD symptoms were suboptimally related to the three parenting styles. Further, two parent–child pathology interaction effects were found, indicating that fathers with high ADHD symptoms and mothers with high ASD symptoms reported to use a more permissive parenting style only towards their unaffected child. The results highlight the negative effects of paternal ADHD symptoms on parenting styles within families with ASD (+ADHD) affected offspring and the higher permissiveness towards unaffected offspring specifically when paternal ADHD and/or maternal ASD symptoms are high. Parenting training in these families may be beneficial for the well-being of all family members.     

Examination of Bidirectional Relationships Between Parent Stress and Two Types of Problem Behavior in Children with Autism Spectrum Disorder

Path analysis within a structural equation modeling framework was employed to examine the relationships between two types of parent stress and children’s externalizing and internalizing behaviors over a 4-year period, in a sample of 184 mothers of young children with autism spectrum disorder. Parent stress was measured with the Parenting Stress Index-Short Form and child behavior was measured with Child Behavior Checklist/1.5–5. Across all time points, parent general distress predicted both types of child behaviors, but not vice versa. In addition, there was modest evidence of a bidirectional relationship between parenting distress and both types of child behaviors from 12 months post-diagnosis to age 6. Results are compared to previous work in this area, with implications for early intervention.     

Parental wellbeing of Iranian families with children who have developmental disabilities

To date, most research with families who have a child with developmental disabilities has been undertaken in English speaking countries. Poorer health, allied with increased levels of stress has been commonly reported for mothers but less is known about the impact on fathers and on overall family functioning. This study aimed to document the correlates of these parental impacts with Iranian mothers and fathers who had children with either intellectual disabilities (ID) or with autism spectrum disorders (ASD). In all 121 parents (69 mothers and 52 fathers from 94 families) who had a child with a diagnosis of ADS, along with 115 parents of children with ID (83 mothers and 32 fathers from 101 families) volunteered to take part in the study. Each participant completed through interview standardised rating scales of parenting stress, emotional well-being, family functioning and satisfaction with caring role along with demographic information and details of informal supports. Structural Equation Modeling identified that family functioning was much poorer in families whose child had ASD and both mothers and fathers reported higher levels of stress. Poorer emotional well-being contributed to higher stress and was more frequent among mothers, single parents and those whose children had behaviour problems. Having other dependents living at home and more sources of informal support improved the emotional wellbeing of parents but not their stress or family functioning. Parents who derived greater satisfaction from their caring role tended to have better emotional health and less stress. Although the impact on Iranian parents of having a child with developmental disabilities is broadly similar to those of parents in other cultures, there are indications that children with ASD present distinct challenges to these families. The model derived in this study is a useful guide both for further research as well as family-centred interventions.     

Adaptation and validation of the Parental Behaviour Scale for Autism Spectrum Disorder in Chinese parents

BackgroundThe present study aimed to adapt and examine the psychometric properties of the Parental Behaviour Scale - ASD (PBS-A) in Chinese parents of young children with ASD.MethodsThe translated version of the PBS-A was administered to 416 parents of young children with ASD (sample 1) to examine the construct validity and internal consistencies. One hundred and five of them (sample 2) were followed-up a month later to examine the test-retest reliability. The Alabama Parenting Questionnaire (APQ), the Strength and Difficulties Questionnaire (SDQ) and the Autism Parenting Stress Inventory (APSI) were administered along with the Chinese version of the PBS-A (C-PBS-A) in Sample 3 (n = 110) to examine the criterion validity of the scale.ResultsThe original structure was not replicated, and a new seven-factor structure containing 41 items was determined using exploratory factor analysis. There were four dimensions measuring shared parenting behaviors with typically developing children and three dimensions measuring ASD-specific parenting behaviors. The internal consistencies and test-retest reliabilities of the C-PBS-A were acceptable. The positive correlations among subscales of the C-PBS-A and similar dimensions in the APQ supported good convergent validity. In support of predictive validity, supportive dimensions in the C-PBS-A were negatively correlated with children’s behavioral problems and parenting stress, while negative control dimensions were positively correlated with these two variables.ConclusionThe Chinese version of the Parental Behaviour Scale (ASD) has good validity and reliability. It can be used to measure the parenting behaviors among Chinese parents of young children with ASD in future research.     

Sleep disturbances in children newly enrolled in elementary school are associated with parenting stress in China

ObjectiveThis study aimed to investigate the prevalence of children's sleep disturbances among students newly enrolled in elementary school, and explored the association between the two during the child's transition from kindergarten to elementary school.MethodsIn 2019, a cross-sectional study was conducted among 1,510 newly enrolled school kids and their parents in Beijing. Children's sleep characteristics were evaluated using the Children's Sleep Habits Questionnaire (CSHQ), and parenting stress characteristics were assessed with the Parenting Stress Index-Short Form (PSI-SF). Logistic regression models were used to analyze the association between children's sleep and parenting stress.ResultsA total of 77.9% of children newly enrolled in elementary school had sleep disturbances and 15.6% of parents had experienced parenting stress. When examining the relationship between children's sleep disturbances and parenting stress, monthly family income over US$1,550 was a protective factor and children with sleep disturbances were associated with higher risk of parenting stress. Two subscales from the CSHQ were associated with higher parenting stress risk: sleep duration and daytime sleepiness. Similarly, parents experiencing parenting stress had children with higher risk of sleep disturbances. This risk was also higher for children from parents screening positive in the PSI-SF subscales for parental distress and difficult child.ConclusionsWe found that children's sleep disturbances and parenting stress were common and there was a bidirectional association between the two during this transition time. Schools and communities need to provide timely psychological support for children and parents to address major stressors.     

The Factors Predicting Stress,Anxiety and Depression in the Parents of Children with Autism

The factors predicting stress, anxiety and depression in the parents of children with autism remain poorly understood. In this study, a cohort of 250 mothers and 229 fathers of one or more children with autism completed a questionnaire assessing reported parental mental health problems, locus of control, social support, perceived parent–child attachment, as well as autism symptom severity and perceived externalizing behaviours in the child with autism. Variables assessing parental cognitions and socioeconomic support were found to be more significant predictors of parental mental health problems than child-centric variables. A path model, describing the relationship between the dependent and independent variables, was found to be a good fit with the observed data for both mothers and fathers.     

The Reciprocal Relationship of ASD,ADHD, Depressive Symptoms and Stress in Parents of Children with ASD and/or ADHD

This study investigated the role of parental Autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and depressive symptoms on parenting stress in 174 families with children with ASD and/or ADHD, using generalized linear models and structural equation models. Fathers and mothers reported more stress when parenting with their child with ASD and/or ADHD than when parenting with the unaffected sibling; they also experienced more stress than a norm population. Depressive symptoms were most pronounced in the parents of children with ASD and ASD+ADHD. Spouse correlations were found for ASD, depression, and parenting stress. Paternal ASD and maternal ADHD symptoms were related to increased parenting stress, and parental ADHD symptoms with depressive symptoms and parenting stress. The results highlight the increased burden of raising a child with ASD and/or ADHD and the reciprocal relationship this has with parents’ ASD, ADHD, and depressive symptoms, and levels of stress.     

6个月婴儿母亲育儿压力调查

目的:调查南京市主城区6个月婴儿母亲的育儿压力,并分析相关的影响因素。方法:采用简式育儿压力问卷(PSI-SF)和自编基本情况调查表对随机抽取的南京市11个主城区420对6个月婴儿及婴儿母亲进行调查与分析。结果:母亲的文化程度与育儿压力呈负相关;婴儿的性别、家庭收入及母亲年龄与母亲的育儿压力差异无统计学意义。结论:婴儿母亲的受教育程度与婴儿母亲的育儿压力有显著相关性。     

Predictors of parenting stress among Malaysian mothers of children with Down syndrome

Background Having children with intellectual disability can be stressful for most parents. Currently there are very few studies focusing on parenting stress among mothers of children with Down syndrome (DS) in Asia. The present study examined the level of parenting stress experienced by Malaysian mothers of children with DS and evaluated the child and maternal factors that contributed to parenting stress based on Hill's ABC‐X Model (Hill 1949). Methods We conducted a cross‐sectional study of mothers of children with DS between the ages of 2–12 years during February–June 2008 in Kedah, a state in Peninsular Malaysia. We used self‐administered questionnaires to gather data on parenting stress, child's birth history and current behavioural problems, as well as the maternal sociodemographic characteristics, coping styles and psychological well‐being. Parental Stress Scale (PSS) was used to assess parenting stress. Measures of child's behavioural problem using Pediatric Symptom Checklist, mother's coping style using Carver et al. (1989 ) COPE inventory and their psychological well‐being using Lovibond and Lovibond (1995 ) DASS21, a scale assessing depression, anxiety and stress were also carried out. Results The 147 mothers who participated in the study had an average age of 43.1 years (SD = 7.6 years), of whom 94.6% were married, 57.1% had secondary level education and 28.6% were working outside their home. Based on PSS, mean parenting stress was 37.6 (SD = 8.1). Parenting stress was significantly higher among mothers who reported having children with behavioural problems. However, parenting stress was modified by positive coping styles and negative maternal psychological well‐being. The final model based on hierarchical regression analysis identified maternal depression and lack of acceptance as significant predictors of parenting stress rather than child's behavioural problems. Conclusion Mean parenting stress among mothers of children with DS significantly differed by behavioural problems in their children. Parenting stress is also significantly correlated with frequent use of acceptance, religious and optimist coping styles, and presence of maternal depressive, anxiety and stress symptoms. However, hierarchical regression analysis identified maternal depression and lack of acceptance of having a child with DS as the most significant predictors of parenting stress in these mothers.     

Self-reported depressive symptoms and parental stress in mothers and fathers who bring their infants to an infant mental health clinic

Background: The parental functioning and its influence upon infant mental health development have been extensively studied but there are few clinical studies investigating less severe psychiatric problems among mothers and fathers in the same family. Aim: This study focuses on the emotional well-being of mothers and fathers who bring their infants to an Infant Mental Health Clinic. Methods: The studied sample is comprised of 63 families with 0–47-month-old infants where the mothers completed the Center for Epidemiological Study—Depression Scale (CES-D), including 43 families in which the CES-D was completed by both parents. In 44 families, the mothers also filled in the Swedish Parental Stress Questionnaire (SPSQ), including 32 where the SPSQ was completed by both parents. The children were independently classified with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0–3). Results: Altogether, 54% of the mothers and 11% of the fathers reported depressive symptoms above the CES-D clinical cut-off. Self-rated depressive symptoms and parental stress were strongly related. The mothers' self-rated depressive symptoms were associated with the severity of their infant's problems, but the association was not specific to the DC 0–3 Axis I classification. The mothers' stress level was marginally related to DC 0–3 Axis II relationship classification. Conclusion: The results indicate that the inclusion of systematic parental self-ratings in infant mental health assessments could add clinical information facilitating the planning of family oriented interventions.     

Parenting stress and coping styles in mothers and fathers of pre‐school children with autism and Down syndrome

Background The study examined the profile of stress in mothers and fathers of preschool children with autism, Down syndrome and typically developing children. A further aim was to assess the association between parenting stress and coping style. Methods A total of 162 parents were examined using Holroyd's 66‐item short form of Questionnaire of Resources and Stress for Families with Chronically Ill or Handicapped Members and the Coping Inventory for Stressful Situations by Endler and Parker. Results and Conclusions The results indicated a higher level of stress in parents of children with autism. Additionally, an interaction effect was revealed between child diagnostic group and parent's gender for two scales of parenting stress: dependency and management and limits of family opportunities. Mothers of children with autism scored higher than fathers in parental stress; no such differences were found in the group of parents of children with Down syndrome and typically developing children. It was also found that parents of children with autism differed from parents of typically developing children in social diversion coping. Emotion‐oriented coping was the predictor for parental stress in the samples of parents of children with autism and Down syndrome, and task‐oriented coping was the predictor of parental stress in the sample of parents of typically developing children. The results strongly supported earlier findings on parenting stress in parents of children with autism. They also shed interesting light on the relationship between coping styles and parental stress.     

Parenting stress,salivary biomarkers,and ambulatory blood pressure in mothers of children with Autism Spectrum Disorders

Parenting a child with an Autism Spectrum Disorder (ASD) is often associated with high levels of stress. This in turn can undermine the success of early intervention, and lead to poorer health outcomes for parents. The present study investigated the effects of parenting a child with an ASD on self-reported parenting stress, salivary biomarkers, and 24-h ambulatory blood pressure. Seventy-four mothers of 2–14 year olds with an ASD diagnosis completed a questionnaire booklet, which contained measures of parenting stress, and parent and child characteristics. Mothers wore an ambulatory blood pressure monitor, which collected systolic and diastolic blood pressure and heart rate over a 24-h period. Saliva samples were collected for the purpose of measuring cortisol and alpha-amylase levels. High levels of parenting stress and anxiety, and moderately high levels of depression were reported. Mothers were found to have low cortisol levels, suggesting dysregulation of the HPA-axis and cortisol profile. Hierarchical multiple regression analyses revealed that quantity of unmet service needs, sleep problems, socialisation deficits, adaptive behaviour, and the coping strategies of self-blame and behavioural disengagement predicted maternal outcomes. Findings are discussed in relation to their implications for supporting parents of children with ASD.     

The contribution of marital quality to the well-being of parents of children with developmental disabilities

Background This study examines the contribution of the marital relationship to the well‐being of both mothers and fathers of children with developmental disabilities. Parent well‐being is conceptualized in terms of mental health, parenting stress and parenting efficacy. Methods These analyses are based on data from 67 families participating in the Early Intervention Collaborative Study, an ongoing longitudinal investigation of the development of children with disabilities and the adaptation of their families. Multidimensional assessment techniques were used to collect data from married mothers and fathers and their child with a disability. Mother and father data were analysed separately using parallel hierarchical regression models. Results For both mothers and fathers, greater marital quality predicted lower parenting stress and fewer depressive symptoms above and beyond socio‐economic status, child characteristics and social support. In relation to parenting efficacy, marital quality added significant unique variance for mothers but not for fathers. For fathers, greater social support predicted increased parenting efficacy. Child behaviour was also a powerful predictor of parental well‐being for both mothers and fathers. Conclusion The findings support the importance of the marital relationship to parental well‐being and illustrate the value of including fathers in studies of children with developmental disabilities.