Families of adolescents and adults with autism spectrum disorders in Taiwan: The role of social support and coping in family adaptation and maternal well-being

In this study we examined differences in social support and coping between mothers of adolescents and adults with an autism spectrum disorder (ASD) in Taiwan and the United States and to investigate the effects of social support and coping strategies on family adaptation and maternal well-being. Participants were 76 Taiwanese mothers who had at least one son or daughter with an ASD (10 years old and older), and a comparison group of 325 mothers in the United States matched on the age range of the child with an ASD. Mothers completed self-administered, written questionnaires and participated in an interview. Taiwanese mothers reported significantly greater use of problem-focused and emotion-focused coping strategies than did mothers in the United States. For Taiwanese families, greater use of problem-focused coping strategies was associated with lower levels of depressive symptoms and anxiety. Emotion-focused coping mediated the relationships between ethnicity/culture and several outcome measures: family adaptability, family cohesion, and maternal depressive symptoms. The higher levels of emotion-focused coping in Taiwanese mothers appeared to account for their lower levels of family adaptability and cohesion and higher levels of maternal depressive symptoms. The results from this cross-cultural study helped determine the role of social support and coping strategies in family adaptation and maternal well-being in families of individuals with an ASD in each culture. Implications for service delivery are discussed.     

Coping strategies,caregiving burden,and depressive symptoms of Taiwanese mothers of adolescents with autism spectrum disorder

Little research focuses on the caregiving experiences of Taiwanese mothers of adolescents with autism spectrum disorder (ASD). The effects of the caregiving burden and coping strategies on the depressive symptoms of 60 of these mothers were examined. The adolescents they cared for ranged from 10 to 19 years old (mean age: 14.7 years). Mothers completed self-report written questionnaires. Findings indicated that greater use of problem-focused rather than emotion-focused coping was generally associated with lower levels of caregiver burden and fewer depressive symptoms. Problem-focused coping acted as a buffer when caregiving burdens were high. Specifically, actively confronting, planning, and suppressing competing activities as coping strategies moderated the effect of the caregiving burden on the depressive symptoms of these mothers. This significant buffering effect reflected adaptation to the caregiving burden. Awareness of the effects of coping strategies on maternal well-being could serve as a valuable guide for practitioners.     

Mothers of adolescents and adults with autism: parenting multiple children with disabilities

We examined types of disabilities in siblings from a large sample of families of adolescents and adults with autism spectrum disorders (ASD) and the impact of another child with a disability on maternal and family well-being. The most frequent disabilities in siblings were attention and hyperactivity (4.6%) and autism spectrum (2.4%) disorders and psychiatric (2.1%) and learning (2.0%) disabilities. Mothers parenting another child with a disability (in addition to the child with ASD) had higher levels of depressive symptoms and anxiety and lower family adaptability and cohesion compared with mothers whose only child with a disability had ASD (matched on child age and family size). Findings are discussed with respect to understanding the needs of such families, including service provision.     

The effects of coping style,social support,and behavioral problems on the well-being of mothers of children with Autism Spectrum Disorders in Lebanon

The present study examined the effects of coping styles, social support, and child's behavioral symptoms on the well-being of 65 mothers of children with Autism Spectrum Disorders (ASD) in Lebanon. Comparisons to the well-being of 98 mothers of typically developing children were also drawn. Regression analyses showed that disengagement and distraction coping predicted poor well-being, whereas cognitive reframing showed a correlation with better well-being levels. A significant correlation was found between child's behavioral problems and maternal well-being. T-test analyses revealed that mothers of children with ASD differed in terms of coping styles used. Additionally, mothers of children with ASD showed lower levels of perceived social support. Well-being was significantly better for mothers of typically developing children. Study limitations and implications are discussed.     

Daily Experiences Among Mothers of Adolescents and Adults with Autism Spectrum Disorder

In the present study, 96 co-residing mothers of adolescents and adults with an autism spectrum disorder (ASD) participated in an 8-day diary study and reported on their daily experiences. In comparison with a nationally representative sample of mothers of children without disabilities, mothers of adolescent and adult children with ASD spent significantly more time providing childcare and doing chores, and less time in leisure activities. Fatigue, arguments, avoided arguments, and stressful events were also more common among mothers of individuals with ASD. However, mothers of individuals with ASD reported similar levels of positive interactions and volunteerism as the comparison group. Daily experiences were subsequently related to well-being in both groups. These findings highlight the need for family support services.     

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.     

Adolescent Siblings of Individuals with an Autism Spectrum Disorder: Testing a Diathesis-Stress Model of Sibling Well-Being

The purpose of this study was to test a diathesis-stress model of well-being for siblings who have a brother or sister with an autism spectrum disorder (ASD). Data were collected from 57 adolescents and their mothers. Sisters reported higher levels of depressive and anxiety symptoms than brothers. Having a family history of ASDs was associated with depressive, but not anxiety, symptoms. A high level of maternal depression was also associated with more depressive and anxiety symptoms. A diathesis-stress model was partially supported, primarily through the findings that sibling sub-threshold autism characteristics were associated with depressive and anxiety symptoms in siblings, but only in the presence of a high number of stressful life events.     

Transition and change in adolescents and young adults with autism: longitudinal effects on maternal well-being

We investigated how change in the characteristics of 140 adolescents and young adults with an autism spectrum disorder (ASD) would predict subsequent change in maternal well-being and in the quality of the mother-child relationship. Overall patterns of improvement in maternal well-being and mother-child relationship quality were observed during the study. When the son or daughter had declining behavior problems, were prescribed more psychotropic medications, and exited from high school during the study period, mothers' well-being and perception of relationship quality improved to a greater extent. In addition, improvements in maternal well-being and relationship quality were observed in mothers of daughters, in mothers of individuals with mental retardation as well as ASD, and in mothers of those in better health.     

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.     

Adolescents and Adults with Autism with and without Co-morbid Psychiatric Disorders: Differences in Maternal Well-Being

This study investigated the associations between the characteristics of adolescents and adults with autism spectrum disorders (ASD) and maternal well-being. Two groups were compared: mothers of adolescents and adults with ASD and co-morbid psychiatric disorders (n = 142) and mothers whose sons or daughters had a single diagnosis of ASD (n = 130). Individuals with co-morbid psychiatric disorders had higher levels of repetitive behaviors, asocial behavior, and unpredictability of behavior than their counterparts with ASD only. They also had poorer rated health as well as more frequent gastrointestinal problems and sleep problems. Mothers of sons and daughters with ASD and co-morbid psychiatric disorders reported higher levels of burden and a poorer quality parent-child relationship than mothers of sons and daughters with ASD only. Higher levels of asocial behavior, unpredictability of behavior, and poorer health in sons and daughters with ASD were predictive of greater burden in mothers and a poorer quality parent-child relationship.     

Anxiety and Sensory Over-Responsivity in Toddlers with Autism Spectrum Disorders: Bidirectional Effects Across Time

This report focuses on the emergence of and bidirectional effects between anxiety and sensory over-responsivity (SOR) in toddlers with autism spectrum disorders (ASD). Participants were 149 toddlers with ASD and their mothers, assessed at 2 annual time points. A cross-lag analysis showed that anxiety symptoms increased over time while SOR remained relatively stable. SOR positively predicted changes in anxiety over and above child age, autism symptom severity, NVDQ, and maternal anxiety, but anxiety did not predict changes in SOR. Results suggest that SOR emerges earlier than anxiety, and predicts later development of anxiety.     

Social Support and Well-being at Mid-Life Among Mothers of Adolescents and Adults with Autism Spectrum Disorders

The present study investigated the impact of social support on the psychological well-being of mothers of adolescents and adults with ASD (n?=?269). Quantity of support (number of social network members) as well as valence of support (positive support and negative support) were assessed using a modified version of the "convoy model" developed by Antonucci and Akiyama (1987). Having a larger social network was associated with improvements in maternal well-being over an 18-month period. Higher levels of negative support as well as increases in negative support over the study period were associated with increases in depressive symptoms and negative affect and decreases in positive affect. Social support predicted changes in well-being above and beyond the impact of child behavior problems. Implications for clinical practice are discussed.     

Daily Health Symptoms of Mothers of Adolescents and Adults with Fragile X Syndrome and Mothers of Adolescents and Adults with Autism Spectrum Disorder

Health symptoms of mothers of adolescents and adults with fragile X syndrome (FXS; n?=?112) were compared to a nationally-representative sample of mothers of similarly-aged children without disabilities (n?=?230) as well as to a sample of mothers of adolescents and adults with autism spectrum disorders (ASD; n?=?96). Health symptoms experienced in the previous 24?h were recorded during 8 consecutive days of a daily diary study. Both mothers of a son or daughter with FXS and mothers of a son or daughter with ASD had a higher proportion of days with headaches, backaches, muscle soreness, fatigue, and hot flashes than mothers of children without disabilities. Mothers of children with disabilities appear to be at particular risk for health problems, highlighting a need for comprehensive services for families across the lifespan.     

Fatigue, Stress and Coping in Mothers of Children with an Autism Spectrum Disorder

Raising a child with an autism spectrum disorder (ASD) can be exhausting, which has the potential to impact on parental health and wellbeing. The current study investigated the influence of maternal fatigue and coping on the relationship between children’s problematic behaviours and maternal stress for 65 mothers of young children (aged 2–5 years) with ASDs. Results showed that maternal fatigue but not maladaptive coping mediated the relationship between problematic child behaviours and maternal stress. These findings suggest child behaviour difficulties may contribute to parental fatigue, which in turn may influence use of ineffective coping strategies and increased stress. The significance of fatigue on maternal wellbeing was highlighted as an important area for consideration in families of children with an ASD.     

The well-being of mothers of adolescents with developmental disabilities in relation to medical care utilization and satisfaction with health care

Parents of children with disabilities have been found to be more likely to experience stress and depressive symptoms than parents of typically developing children as a result of the increased challenges inherent in their parenting role. This study investigated the utilization of and satisfaction with adolescent health care services reported by mothers and their relation to maternal well-being. Participants included 73 mothers and their adolescents with developmental disabilities who had been recruited as infants and toddlers from early intervention programs to participate in a longitudinal investigation, the Early Intervention Collaborative Study. Data were collected through parent reports and structured assessments with adolescents. Regression analyses were conducted to test whether utilization and maternal satisfaction with care related to maternal depressive symptoms or parenting stress after controlling for child and family characteristics. The results demonstrated that both utilization and maternal satisfaction with health care added unique variance in predicting lower levels of maternal stress and depressive symptoms.     

Religiosity,Spirituality, and Socioemotional Functioning in Mothers of Children with Autism Spectrum Disorder

Religious beliefs, religious activities, and spirituality are coping resources used by many mothers of children with autism spectrum disorder (ASD). This study examined whether and how these resources were related to maternal socioemotional functioning. Mothers of children with ASD completed questionnaires assessing religiosity, spirituality, and a wide range of outcome variables, including stress, depression, self-esteem, life satisfaction, positive affect, and sense of control. Analyses revealed that religious beliefs and spirituality were associated with better positive outcomes and, to a lesser extent, lower levels of negative outcomes. Of the two predictors, spirituality accounted for more unique variance in positive outcomes. In contrast, religious activities were related to more negative outcomes and lower levels of positive outcomes.     

Coping,distress, and well-being in mothers of children with autism

As is the case in stress research generally, studies examining the relationship between coping and mental health outcomes in parents of children with autism frequently classify parental coping methods as being either problem- or emotion-focused. We argue that this dichotomization of coping strategies oversimplifies the way parents respond to their child's autism. In the present study, the coping methods employed by 113 mothers of children with autism were investigated using the Brief COPE (Carver et al., 1989). Exploratory factor analysis of Brief COPE subscales identified four reliable coping dimensions: engagement coping, distraction coping, disengagement coping, and cognitive reframing coping. In addition, using multiple regression, we examined the relationship of coping strategies to negative and positive maternal outcomes (depression, anger, and well-being). In general, maternal use of avoidant coping (distraction and disengagement) was found to be associated with increased levels of maternal depression and anger, while use of cognitive reframing was associated with higher levels of maternal well-being. In several instances, child characteristics, particularly severity of child maladaptive behavior, moderated the effect of coping on maternal outcomes. Study findings are discussed in light of previous research in the area; in addition, study limitations and clinical implications are highlighted.     

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.     

Optimism,Social Support,and Well-Being in Mothers of Children with Autism Spectrum Disorder

This study used structural equation modeling to examine the relationship between multiple sources of social support (e.g., partner, family, and friends), optimism, and well-being among mothers of children with ASD. Social support was examined as a mediator and moderator of the optimism-maternal well-being relationship. Moreover, the role of optimism as a mediator of the social support-maternal well-being relationship was also evaluated. Results revealed that family support was associated with increased optimism that, in turn, predicted higher levels of positive maternal outcomes and lower levels of negative maternal outcomes. In addition, partner and friend support were directly associated with maternal outcomes. Implications for the development of interventions directed at increasing the quality of social support networks are discussed.     

The relationship between race and comorbid symptoms in infants and toddlers with autism spectrum disorder

Researchers have indicated that persons with autism spectrum disorder (ASD) population evince higher rates of comorbid symptoms. While the relationship between comorbid symptoms and factors such as autism symptom severity, IQ level, age, communication abilities, and degree of social impairment were previously examined, there has been limited research on the effect of race in this area. The current study examined the potential role of race in comorbid symptoms in toddlers with ASD and atypically developing toddlers without a diagnosis of ASD using The Baby and Infant Screen for Children with aUtIsm Traits – Part 2 (BISCUIT-Part 2). Based on the current findings, African-American toddlers evinced higher rates of comorbid symptoms than Caucasian toddlers and toddlers of other races. In addition, toddlers with ASD evinced higher rates of comorbid symptoms than atypically developing toddlers without a diagnosis of ASD. Implications regarding these findings are discussed.