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Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, Jones EJH, Jones RM, Pickles A, State MW, Taylor JL, Veenstra-VanderWeele J. Autism spectrum disorder. Nat Rev Dis Primers 2020; 6:5. [PMID: 31949163 PMCID: PMC8900942 DOI: 10.1038/s41572-019-0138-4] [Citation(s) in RCA: 574] [Impact Index Per Article: 143.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication and repetitive behaviours, highly restricted interests and/or sensory behaviours beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries. Although gross brain pathology is not characteristic of autism, subtle anatomical and functional differences have been observed in post-mortem, neuroimaging and electrophysiological studies. Initially, it was hoped that accurate measurement of behavioural phenotypes would lead to specific genetic subtypes, but genetic findings have mainly applied to heterogeneous groups that are not specific to autism. Psychosocial interventions in children can improve specific behaviours, such as joint attention, language and social engagement, that may affect further development and could reduce symptom severity. However, further research is necessary to identify the long-term needs of people with autism, and treatments and the mechanisms behind them that could result in improved independence and quality of life over time. Families are often the major source of support for people with autism throughout much of life and need to be considered, along with the perspectives of autistic individuals, in both research and practice.
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Affiliation(s)
- Catherine Lord
- Departments of Psychiatry and School of Education, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Traolach S Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Guillaume Dumas
- Institut Pasteur, UMR3571 CNRS, Université de Paris, Paris, France
| | | | - Emily J H Jones
- Centre for Brain & Cognitive Development, University of London, London, UK
| | - Rebecca M Jones
- The Sackler Institute for Developmental Psychobiology, New York, NY, USA
- The Center for Autism and the Developing Brain, White Plains, NY, USA
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew W State
- Department of Psychiatry, Langley Porter Psychiatric Institute and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Julie Lounds Taylor
- Department of Pediatrics and Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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202
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Examining the Links Between Received Network Support and Marital Quality Among Mothers of Children with ASD: A Longitudinal Mediation Analysis. J Autism Dev Disord 2019; 50:960-975. [PMID: 31853756 DOI: 10.1007/s10803-019-04330-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Employing a cohort sequential design and multilevel modeling, the direct and indirect effects (via depressed mood, emotional wellbeing, and perceived support) of received network support on marital quality were assessed over a 7-year period (child age 7-14) on 96 married or cohabiting mothers of children with ASD. Findings indicated several significant direct and indirect effects affecting change within mothers over time, with effects varying by whether the support source was a spouse or partner, family members, or friends. In addition, one moderated mediation effect was noted, with the indirect effect of received spousal support on marital quality via perceived spousal support retaining significance only at low and moderate levels of child problem behavior severity. Study strengths, limitations, and clinical implications are discussed.
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203
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Effectiveness of Parent Education in Pivotal Response Treatment on Pivotal and Collateral Responses. J Autism Dev Disord 2019; 49:3477-3493. [PMID: 31127486 PMCID: PMC6667419 DOI: 10.1007/s10803-019-04061-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In two studies, we investigated the effectiveness of parent education in Pivotal Response Treatment (PRT) on parent-created opportunities and spontaneous child initiations in two community-based treatment facilities for children with autism spectrum disorder (ASD). Changes in parental stress and self-efficacy were explored. Participants were 26 parents and their children who participated in group (Study 1) or individual (Study 2) parent education in PRT. Results indicated that group-based parent education resulted in moderate increases in opportunities, functional initiations, and empathic social initiations. Furthermore, parental stress reduced and self-efficacy increased. Individual parent education resulted in large increases in opportunities and functional initiations, but parental stress and self-efficacy did not change. Implications for clinical practice and directions for future research are discussed.
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204
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Mello C, Rivard M, Terroux A, Mercier C. Quality of Life in Families of Young Children With Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:535-548. [PMID: 31756145 DOI: 10.1352/1944-7558-124.6.535] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The present study investigated family quality of life (FQOL) as experienced by 493 mothers and fathers (295 families) of young children with autism spectrum disorder (ASD) prior to receiving early intervention services in the province of Québec. These families were most satisfied with their physical and material well-being and least satisfied with their family interactions. Children's level of functioning across various standardized and subjective measures were positively associated with parents' FQOL. In both parents, family characteristics associated with financial and personal resources were also linked to FQOL. The child's age and the number of children were associated with mothers' FQOL. Overall, these findings provide a portrait of ASD-related stressors and resources relevant to both parents during the early childhood period.
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Affiliation(s)
- Catherine Mello
- Catherine Mello, The Pennsylvania State University, Berks; Mélina Rivard and Amélie Terroux, Université du Québec à Montréal; and Céline Mercier, Université de Montréal, Québec
| | - Mélina Rivard
- Catherine Mello, The Pennsylvania State University, Berks; Mélina Rivard and Amélie Terroux, Université du Québec à Montréal; and Céline Mercier, Université de Montréal, Québec
| | - Amélie Terroux
- Catherine Mello, The Pennsylvania State University, Berks; Mélina Rivard and Amélie Terroux, Université du Québec à Montréal; and Céline Mercier, Université de Montréal, Québec
| | - Céline Mercier
- Catherine Mello, The Pennsylvania State University, Berks; Mélina Rivard and Amélie Terroux, Université du Québec à Montréal; and Céline Mercier, Université de Montréal, Québec
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205
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Blacher J, Baker BL. Collateral Effects of Youth Disruptive Behavior Disorders on Mothers' Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development. J Autism Dev Disord 2019; 49:2810-2821. [PMID: 29071563 DOI: 10.1007/s10803-017-3347-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disruptive behavior disorders were assessed in 160 youth aged 13 years, with Autism Spectrum Disorder (ASD, n = 48), intellectual disability (ID, n = 28), or typical development (TD, n = 84). Mothers' reported collateral effects on their psychological adjustment were related to both youth disability status and clinical level behavior disorders. More youth with ASD or ID had clinical level behavior disorders than their TD peers, and their mothers reported significantly higher personal stress and psychological symptoms, as well as lower positive impact of the youth on the family. The youth's clinical level behavior disorders accounted for these differences more than the diagnostic status. Mothers high in dispositional optimism reported the lowest stress and psychological symptoms in relationship to youth behavior challenges.
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Affiliation(s)
- Jan Blacher
- Graduate School of Education, University of California, UCR, Sproul Hall, Riverside, CA, 92521, USA.
| | - Bruce L Baker
- Department of Psychology, University of California, Los Angeles (UCLA), Franz Hall, Los Angeles, CA, 90095, USA
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206
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Kasperzack D, Schrott B, Mingebach T, Becker K, Burghardt R, Kamp-Becker I. Effectiveness of the Stepping Stones Triple P group parenting program in reducing comorbid behavioral problems in children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:423-436. [DOI: 10.1177/1362361319866063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Children with autism spectrum disorders often exhibit comorbid behavioral problems. These problems have an impact on the severity of the core symptoms, the progression of the disorder as well as on the families’ quality of life. We evaluated the effectiveness of the Stepping Stones Triple P group parent training program as a supplementary intervention in the treatment of children with autism spectrum disorder. Therefore, we employed a single group repeated measures design and assessed child variables via parents’ and teachers’ judgments at four successive time points. The participants were parents of 24 children with autism spectrum disorder aged between 3.6 and 12 years. We found a significant reduction of comorbid behavioral problems in the children, primarily in the parents’ judgment at follow-up. Furthermore, a reduction of the autism spectrum disorder core symptoms emerged. The teachers’ judgment particularly revealed an improvement in children’s social relationships. Effect sizes were large ( ƞ2 ranging from 0.14 to 0.23). The findings demonstrate the effectiveness of the Stepping Stones Triple P as a supplementary intervention for reducing comorbid behavioral problems in the treatment of children with autism spectrum disorder. Higher parental self-efficacy and parental attributions, including parents’ ability to influence child problem behaviors, are discussed as important factors for the effectiveness of Stepping Stones Triple P.
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207
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Factor RS, Ollendick TH, Cooper LD, Dunsmore JC, Rea HM, Scarpa A. All in the Family: A Systematic Review of the Effect of Caregiver-Administered Autism Spectrum Disorder Interventions on Family Functioning and Relationships. Clin Child Fam Psychol Rev 2019; 22:433-457. [DOI: 10.1007/s10567-019-00297-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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208
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Boshoff K, Gibbs D, Phillips RL, Wiles L, Porter L. A meta-synthesis of how parents of children with autism describe their experience of advocating for their children during the process of diagnosis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e143-e157. [PMID: 30548710 DOI: 10.1111/hsc.12691] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/23/2018] [Accepted: 10/30/2018] [Indexed: 06/09/2023]
Abstract
The diagnostic process for children with autism can be complex for parents to navigate as they advocate for their child in order to obtain answers to their concerns, and receive the subsequent support they need. Gaining an understanding of parents' experiences during this process, will assist service providers in supporting families adequately. This systematic review was undertaken to consolidate in-depth qualitative data from parents of their experience of advocating for their child with autism, during the process of diagnosis. A qualitative meta-synthesis was conducted, whereby fifteen databases were systematically searched. Twenty-two studies were identified and appraised using an adapted version of the Critical Appraisal Skills Programme tool. Data were synthesised into themes through the steps of review, meta-aggregation, integration, and interpretation. The date range of the included studies spans 1999-2016. The voices of 1,178 parents are presented in this review describing their experiences in two overarching themes: "Pathway to diagnosis-Confusion and not feeling heard"; and "Pursuing diagnosis-Resilience and commitment." Each one of these main themes had sub-themes. Our findings highlight the intense emotional journey for parents during identification of their initial concerns and the formal process of diagnosis, and their perceptions of not being supported by others on this journey. This review illustrates the significant impact that positive experiences with first-line professionals have during the process of diagnosis, and how these experiences lay the foundation for all future relationships with other service providers. As a result, awareness of parents' experiences will assist service providers to reconsider their communication style, information sharing, provision of support and to incorporate parents' contributions in facilitating a more streamlined and more supportive process of diagnosis.
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Affiliation(s)
- Kobie Boshoff
- School of Health Sciences, International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia
| | - Deanna Gibbs
- Nursing, Midwifery & Allied Health Professions, Barts Health NHS Trust, London, UK
| | - Rebecca L Phillips
- ANU Medical School, Centre for Health Stewardship, The Australian National University, Canberra, Australia
| | - Louise Wiles
- School of Health Sciences, International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, Australia
| | - Lisa Porter
- University of South Australia, Adelaide, South Australia, Australia
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209
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Backing the backbones—A feasibility study on the effectiveness of dance movement psychotherapy on parenting stress in caregivers of children with Autism Spectrum Disorder. ARTS IN PSYCHOTHERAPY 2019. [DOI: 10.1016/j.aip.2019.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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210
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Young A, Ferguson-Coleman E, Wright B, Le Couteur A. Parental Conceptualizations of Autism and Deafness in British Deaf Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2019; 24:280-288. [PMID: 30839059 DOI: 10.1093/deafed/enz002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/20/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
The co-occurrence of childhood deafness and autism raises complex challenges for diagnosis and family support. In this article, we explore with hearing and Deaf parents their observations of the interaction between deafness and autism and identify how the intersections of deafness and autism are conceptualized in everyday life. Eight parents participated (two of whom were Deaf BSL users) in semi-structured interviews in either BSL or spoken English. Data analysis was underpinned by a phenomenological approach in the hermeneutic tradition. Findings are discussed in terms of parents' perceptions of the relevance of deafness to their understanding of autism for their particular child, the effects of autism on sign and spoken language development and the relationship between deafness and autism in terms of their own and others' attributions of their children's characteristics. The significance of the findings for parental contributions' to diagnostic assessment and the tailoring of family support are considered.
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Affiliation(s)
- Alys Young
- School of Health Sciences, University of Manchester
| | | | - Barry Wright
- Department of Health Sciences, University of York
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211
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Frye RE. Behaviorally associated changes in neuroconnectivity following autologous umbilical cord blood infusion in young children with autism spectrum disorder. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:S123. [PMID: 31576330 PMCID: PMC6685876 DOI: 10.21037/atm.2019.05.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/21/2019] [Indexed: 01/05/2024]
Affiliation(s)
- Richard E. Frye
- Division of Neurodevelopmental Disorders, Department of Neurology, Barrow Neurological Institute at Phoenix Children’s Hospital, Phoenix, AZ, USA
- Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA
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212
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Brown CE, Borduin CM, Dopp AR, Mazurek MO. The social ecology of aggression in youths with autism spectrum disorder. Autism Res 2019; 12:1636-1647. [PMID: 31206256 DOI: 10.1002/aur.2157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/27/2019] [Indexed: 12/28/2022]
Abstract
This study examined the social-ecological correlates of aggressive behavior in 120 youths with autism spectrum disorder. Youths were divided into three groups based on caregiver reports of the youth's aggressive acts: youths who engaged in acts of both physical and verbal aggression, youths who engaged only in acts of physical aggression, and nonaggressive youths. Caregivers and youths completed self-report instruments and behavior rating inventories that assessed youth individual functioning, family relations, and extrafamilial factors (i.e., peer relations, academic performance). Results showed that youths who engaged in both verbal and physical aggression were characterized by poor sleep quality and victimization by peers, and their caregivers evidenced high levels of distress and avoidant coping. In contrast, youths who were physically but not verbally aggressive were distinguished by difficulties in social interaction and communication. In general, each group of youths who were aggressive experienced more problems with repetitive behaviors, family relations, and academic performance than did their nonaggressive counterparts. The implications of these findings for theory, research, and treatment are discussed. Autism Res 2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present study demonstrated that youths with autism spectrum disorder may be classified by the types of aggressive behaviors that they exhibit: youths who are verbally and physically aggressive, physically aggressive only, or not aggressive. Compared to the nonaggressive group, both groups of youths who were aggressive experienced difficulties in their individual, family, peer, and academic functioning. Youths with both verbal and physical aggression showed the most problems in their functioning.
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Affiliation(s)
| | | | - Alex R Dopp
- University of Arkansas, Fayetteville, Arkansas
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213
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Althoff CE, Dammann CP, Hope SJ, Ausderau KK. Parent-Mediated Interventions for Children With Autism Spectrum Disorder: A Systematic Review. Am J Occup Ther 2019; 73:7303205010p1-7303205010p13. [PMID: 31120831 DOI: 10.5014/ajot.2019.030015] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review was to evaluate the evidence for the effectiveness of parent-mediated interventions on occupational performance of children with autism spectrum disorder (ASD). METHOD We conducted a search of academic databases using terms such as autism spectrum disorder, parent, caregiver, and intervention. Five hundred eighty-two articles were reviewed, and 109 were selected for full-text review. The final analysis included 13 articles. RESULTS Strong evidence was found for the efficacy of parent-mediated intervention for increasing child joint attention. Moderate evidence was found for the improvement of language scores, expressive language, nonverbal communication, initiation and response to interaction, behavior, play, adaptive functioning, ASD symptoms, and social communication. CONCLUSION This systematic review suggests that parent-mediated interventions for children with ASD can improve various aspects of communication and ASD symptoms, with emerging support for occupational performance. Occupational therapy practitioners are well suited to facilitate these interventions to support families with children with autism.
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Affiliation(s)
- Colleen E Althoff
- Colleen E. Althoff, MS, OTR/L, is Occupational Therapist, John H. Stroger Jr. Hospital of Cook County, Chicago; . She was Student, Occupational Therapy Program, University of Wisconsin-Madison, at the time of the study
| | - Caitlin P Dammann
- Caitlin P. Dammann, MS, OTR/L, was Student, Occupational Therapy Program, University of Wisconsin-Madison, at the time of the study
| | - Sarah J Hope
- Sarah J. Hope, MS, OTR/L, was Student, Occupational Therapy Program, University of Wisconsin-Madison, at the time of the study
| | - Karla K Ausderau
- Karla K. Ausderau, PhD, OTR/L, is Assistant Professor, Occupational Therapy Program, and Investigator, Waisman Center, University of Wisconsin-Madison
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214
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Ang KQP, Loh PR. Mental Health and Coping in Parents of Children with Autism Spectrum Disorder (ASD) in Singapore: An Examination of Gender Role in Caring. J Autism Dev Disord 2019; 49:2129-2145. [PMID: 30706349 DOI: 10.1007/s10803-019-03900-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Research has supported the notion that gender plays a significant role in coping and mental health outcome among parents of children with ASD. The current study aims to examine gender role in the relationship between mental health outcome and coping in parents of children with ASD in Singapore. This study involved 97 fathers and 106 mothers of children with ASD completing self-report questionnaires. MANOVA revealed mothers experienced significantly higher stress levels than fathers. Stress was a significant predictor of depression for fathers but not for mothers. Regression analyses found use of active avoidance coping moderated the relationship between stress and depression in both parents. Implications of these findings on intervention are discussed.
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Affiliation(s)
| | - Pek Ru Loh
- National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore, 637616, Singapore
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215
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Wallisch A, Little L, Pope E, Dunn W. Parent Perspectives of an Occupational Therapy Telehealth Intervention. Int J Telerehabil 2019; 11:15-22. [PMID: 31341543 PMCID: PMC6597151 DOI: 10.5195/ijt.2019.6274] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Occupational therapy services delivered via telehealth can support families of young children with autism spectrum disorders (ASD) in everyday routines such as mealtime, bedtime, and play. The aim of the current study was to understand the lived experiences of parents who participated in a 12-week, telehealth-delivered occupational therapy intervention (Occupation-Based Coaching). We used semi-structured interviews and subsequent thematic content analysis to understand how parents perceived the mechanism of service delivery (i.e., videoconferencing) and the content of the intervention. Themes that emerged from the data included Compatibility with Everyday Life, Collaborative Relationship, and Parent Empowerment. Parents expressed how telehealth fit within their daily lives, how telehealth supported a collaborative relationship with the occupational therapist, and how the content of the intervention built a sense of empowerment.
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Affiliation(s)
- Anna Wallisch
- JUNIPER GARDENS CHILDREN'S PROJECT, UNIVERSITY OF KANSAS, KANSAS CITY, KS, USA
| | - Lauren Little
- OCCUPATIONAL THERAPY, RUSH UNIVERSITY, CHICAGO, IL, USA
| | - Ellen Pope
- DUNN AND POPE COACHING, SANTA FE, NM, USA
| | - Winnie Dunn
- DUNN AND POPE COACHING, SANTA FE, NM, USA.,OCCUPATIONAL THERAPY, UNIVERSITY OF MISSOURI, COLUMBIA, MO, USA
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216
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Estes A, Swain DM, MacDuffie KE. The effects of early autism intervention on parents and family adaptive functioning. PEDIATRIC MEDICINE (HONG KONG, CHINA) 2019; 2:21. [PMID: 31583390 PMCID: PMC6776235 DOI: 10.21037/pm.2019.05.05] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This review describes the effects of intervention for young children with autism spectrum disorder (ASD) on parents. Like all children, children with ASD bring both negative and positive experiences for parents and families-from increased resource needs, to higher levels of parenting-related stress, to positive personal growth for family members. It is increasingly recognized that, although children with ASD are the primary targets of early ASD intervention, ASD intervention also impacts parents. From the time emerging developmental concerns begin to be identified, through the process of obtaining a diagnosis and initiating services, parents play a central role in addressing the needs of young children with ASD, including implementing and supporting early intervention. Parents experience the impact of intervention directly, through interaction with providers within the health care and educational systems. Parents also experience indirect impacts of ASD intervention due to accelerated developmental progress of children who are benefitting from services and when children make slower progress than expected or have challenging behaviors. Parental stress and psychological well-being are legitimate targets of intervention and compelling research objectives, needing no additional justification. However, parents are also the major contributors to family adaptive functioning-the activities families employ to support positive outcomes for children with ASD (e.g., family-orchestrated child experiences, parent-child interaction, child health and safety functions; Guralnick, 1997). A parent's ability to carry out adaptive functions is, in part, related to their levels of stress and psychological well-being. Thus, there is a transactional process in which parents are both impacted by and have an impact on ASD interventions for their child. Evaluating the effect of ASD intervention on parents is needed to develop new strategies for helping parents and children with ASD reach their full potential. This review will provide an overview of research on the impact of early ASD intervention on parents. Evidence regarding the impact of three types of intervention (i.e., early intensive behavioral intervention, parent-implemented intervention, and programs directly targeting parent stress) on parent well-being and family adaptive functioning will be reviewed. Potential moderators of the impact of ASD intervention on parents and family adaptive functioning will be discussed. We conclude that research on the impact of ASD intervention on parents of young children with ASD is a promising avenue for improving the lives of children with ASD and their families.
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Affiliation(s)
- Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Deanna M. Swain
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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217
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Profiles of Social and Coping Resources in Families of Children with Autism Spectrum Disorder: Relations to Parent and Child Outcomes. J Autism Dev Disord 2019; 48:2064-2076. [PMID: 29362954 DOI: 10.1007/s10803-018-3467-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study described empirically derived profiles of parents' personal and social coping resources in a sample of 207 families of children diagnosed with autism spectrum disorder. Latent Profile Analysis identified four family profiles based on socieoeconomic risk, coping strategy utilization, family functioning, available social supports, and perceptions of family-centered support. During the time of children's transition to school, parents in the most disadvantaged group experienced the highest levels of parenting stress and depression, and their children had significantly lower adaptive behaviour scores and more parent-reported behavior problems than children in the other three groups. Results highlight the need for systematic surveillance of family risk factors so that supports can be provided to enhance both parental well-being and children's developmental health.
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218
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High Functioning Autism Spectrum Disorders in Adults: Consequences for Primary Caregivers Compared to Schizophrenia and Depression. J Autism Dev Disord 2019; 48:1920-1931. [PMID: 29313177 PMCID: PMC5948267 DOI: 10.1007/s10803-017-3445-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Primary caregivers experience consequences from being in close contact to a person with autism spectrum disorder (ASD). This study used the Involvement Evaluation Questionnaire to explore the level of consequences of 104 caregivers involved with adults with High Functioning ASD (HF-ASD) and compared these with the consequences reported by caregivers of patients suffering from depression and schizophrenia. Caregivers involved with adults with an HF-ASD experience overall consequences comparable to those involved with patients with depression or schizophrenia. Worrying was the most reported consequence. More tension was experienced by the caregivers of ASD patients, especially by spouses. More care and attention for spouses of adults with an HF-ASD appears to be needed.
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219
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Abstract
Autism spectrum disorder (ASD) describes a set of neurodevelopmental disorders. Despite extensive ASD research lasting more than 60 years, its causes are still unknown. Without indicating the etiology, its development cannot be stopped. Over the years, both the definition and diagnostic criteria have developed. The number of ASD incidence is rising. The economical aspect should also be highlighted. This disorder presents particular challenges to affected children, their parents and physicians. The research of ASD, physician activities, policy making and raising the level of awareness must be coordinated. Special attention should be paid to the problem among adults with ASD.
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Affiliation(s)
- Joanna Kałużna-Czaplińska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
| | - Ewa Żurawicz
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
| | - Jagoda Jóźwik-Pruska
- Department of Chemistry, Institute of General and Ecological Chemistry, Lodz University of Technology, Żeromskiego 116 Street, 90-924 Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz, Poland
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Nik Adib NA, Ibrahim MI, Ab Rahman A, Bakar RS, Yahaya NA, Hussin S, Wan Mansor WNA. Predictors of Caregivers' Satisfaction with the Management of Children with Autism Spectrum Disorder: A Study at Multiple Levels of Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101684. [PMID: 31091735 PMCID: PMC6572543 DOI: 10.3390/ijerph16101684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 01/26/2023]
Abstract
Background: Caregivers are the initial gatekeepers in the health care management of children with autism spectrum disorder (ASD). Methods: This cross-sectional study aimed to determine the factors associated with caregivers’ satisfaction with different levels of health care services in managing children with ASD in Kelantan. The satisfaction scores of 227 main caregivers of confirmed ASD children were assessed with a modified Parent Satisfaction Scale (PSS) questionnaire. Results: The analysis showed that caregivers who waited longer for a doctor’s consultation in primary care had a reduced PSS score, whereas caregivers who were satisfied with the waiting time in primary care had higher PSS scores. At the secondary care level, caregivers who possessed at least a diploma had reduced PSS scores, whereas caregivers who were satisfied with both doctors’ consultation times and occupational therapy appointments had higher PSS scores. At the tertiary care level, caregivers with an underlying medical problem and who had children undergoing occupational therapy for two months or more had reduced PSS scores. Nevertheless, the analysis showed that caregivers who were concerned with their children’s sleeping problems, who had been informed about parental support, who were satisfied with speech and occupational therapy appointments, who were satisfied with waiting times at tertiary care clinics, and who were satisfied with their doctor’s knowledge and experience had higher PSS scores. Conclusions: This study elucidated the importance of understanding caregivers’ satisfaction in attaining care for their ASD children and highlighted the need to promote factors that would increase caregivers’ satisfaction with current ASD services.
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Affiliation(s)
- Nik Aida Nik Adib
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
| | - Raishan Shafini Bakar
- Department of Psychiatric, School of Medical Sciences, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
| | - Nor Azni Yahaya
- Department of Pediatric, Hospital Raja Perempuan Zainab II, 15200 Kota Bharu, Kelantan, Malaysia.
| | - Suria Hussin
- Department of Psychiatric, Hospital Raja Perempuan Zainab II, 15200 Kota Bharu, Kelantan, Malaysia.
| | - Wan Nor Arifin Wan Mansor
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
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221
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Schnabel A, Youssef GJ, Hallford DJ, Hartley EJ, McGillivray JA, Stewart M, Forbes D, Austin DW. Psychopathology in parents of children with autism spectrum disorder: A systematic review and meta-analysis of prevalence. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:26-40. [DOI: 10.1177/1362361319844636] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Parents of children with autism spectrum disorder appear to experience high levels of psychological distress, yet little is known about the prevalence of psychological disorders in this population. The aim of this systematic review and meta-analysis was to estimate the proportion of these parents who experience clinically significant psychopathology. Articles reporting proportions of psychological disorders in a sample of parents of children with autism spectrum disorder were located. The initial search returned 25,988 articles. Thirty-one studies with a total sample of 9208 parents were included in the final review. The median meta-analytic proportions were 31% (95% confidence interval = [24%, 38%]) for depressive disorders, 33% (95% confidence interval = [20%, 48%]) for anxiety disorders, 10% (95% confidence interval = [1%, 41%]) for obsessive-compulsive disorder, 4% (95% confidence interval = [0%, 22%]) for personality disorders, 2% (95% confidence interval = [1%, 4%]) for alcohol and substance use disorders and 1% (95% confidence interval = [0%, 5%]) for schizophrenia spectrum disorders. Significant heterogeneity was detected in these categories. Further research is needed to gain more insight into variables that may moderate parental psychopathology. This review and meta-analysis is the first to provide prevalence estimates of psychological disorders in parents of children with autism spectrum disorder.
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Affiliation(s)
| | - George J Youssef
- Deakin University, Australia
- Murdoch Children’s Research Institute, Australia
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222
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Stahmer AC, Dababnah S, Rieth SR. Considerations in implementing evidence-based early autism spectrum disorder interventions in community settings. PEDIATRIC MEDICINE (HONG KONG, CHINA) 2019; 2:18. [PMID: 31565699 PMCID: PMC6764452 DOI: 10.21037/pm.2019.05.01] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Evidence-based practices (EBPs) in early intervention for autism spectrum disorder (ASD) have the potential to improve children's developmental trajectories and address family needs. However, the successful use of EBPs in community early intervention settings requires careful attention to the context in which services are delivered. Implementation science, and specifically the Exploration, Preparation, Implementation, and Sustainment (EPIS) Model, provides a framework to examine context across multiple levels and identify barriers and facilitators to community EBP use. This article identifies several considerations most relevant for early intervention in ASD at the outer and inner context levels, as well as bridging and innovation factors. Outer context considerations include the policies and funding streams surrounding service delivery, the role of advocacy in shaping the service landscape, the availability of appropriate specialists to provide services, and family cultural characteristics. Inner context factors include the individual characteristics of both the children receiving the service as well as the provider delivering the service, in addition to the leadership and organizational climate surrounding the use of a particular EBP. We also discuss considerations of the specific innovation (in this case, EBP early interventions) to be deployed, as well as bridging factors.
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223
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Perceived Stress among Caregivers of Children with Autism Spectrum Disorder: A State-Wide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081468. [PMID: 31027225 PMCID: PMC6517964 DOI: 10.3390/ijerph16081468] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 11/16/2022]
Abstract
Background: Caregivers of children with autism spectrum disorder (ASD) experience increased stress and more significant negative caregiving consequences than those with typically developing children. There is a lack of studies specifically focusing on stress among caregivers with ASD children in Asian countries. The current study examines levels of perceived stress and factors associated with it among caregivers in Kelantan, Malaysia. Methods: In a cross-sectional study, the Malay version of the Perceived Stress Scale (PSS) was administered to 227 caregivers of children with ASD. The caregivers were recruited from ASD databases in four tertiary hospitals in Kelantan and a meeting was set up during the child’s follow-up in the clinic. Multiple linear regression analyses were applied to determine the predictors of perceived stress. Results: The mean total perceived stress score was 20.84 (4.72). This was considered higher than average. Higher perceived stress was significantly predicted among caregivers who live far from the health institution, caregivers who do not own transportation to bring the child to the treatment center, and caregivers who have an ASD child with a learning disability. Conclusion: Caregivers of an ASD child perceived significant stress while taking care of their children. Institutions should alleviate the factors that were predicted to increase the caregivers’ perceived stress to improve the quality of the lives of children and ASD families as a whole.
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224
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Sankey C, Girard S, Cappe E. Evaluation of the social validity and implementation process of a psychoeducational program for parents of a child with Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:101-111. [PMID: 34141403 PMCID: PMC8115530 DOI: 10.1080/20473869.2019.1598721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 02/08/2019] [Accepted: 03/20/2019] [Indexed: 06/12/2023]
Abstract
The aim of this study was to assess the social validity and document the implementation of a psychoeducational program designed to support parents after their child's diagnosis, from both parents' and professionals' perspectives. A complete version (five workshops and five individual follow-ups) and a shortened version (five workshops only) of the program were evaluated. Parents filled in satisfaction questionnaires after every workshop and at the end of the program. Professionals who facilitated the program filled in a specially designed questionnaire to rate the quality of the program and of its implementation, the fidelity of implementation and the parents' responsiveness. In addition, video recordings of the workshops allowed an objective assessment of the fidelity of implementation. Attendance rates were high; parents were satisfied and felt they had made progress. Professionals evaluated positively the quality of the program and of its implementation, and felt parents were responsive. However, minor adaptations had to be made. The program has good social validity, which allowed easy and satisfying implementation, but it does require some flexibility. Overall, this study provides useful insight on the implementation process that may help clinical services to use this evidence-based program effectively.
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Affiliation(s)
- Carol Sankey
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
| | - Sophie Girard
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
| | - Emilie Cappe
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
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225
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Nuske HJ, Hedley D, Tseng CH, Begeer S, Dissanayake C. Emotion Regulation Strategies in Preschoolers with Autism: Associations with Parent Quality of Life and Family Functioning. J Autism Dev Disord 2019; 48:1287-1300. [PMID: 29192379 DOI: 10.1007/s10803-017-3391-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Children with autism experience challenges with emotion regulation. It is unclear how children's management of their emotions is associated with their family's quality of life. Forty-three preschoolers with autism and 28 typically developing preschoolers were coded on emotion regulation strategies used during low-level stress tasks. Parents reported on their quality of life and family functioning, and their child's internalizing and externalizing behaviors. More externalizing behaviors across groups and use of two emotion regulation strategies (self-soothing, deep exhalation) in the autism group predicted lower family quality of life. Findings suggest that children's emotional outbursts and reduced use of passive comforting strategies are linked to lower family quality of life.
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Affiliation(s)
- Heather Joy Nuske
- Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia, PA, USA.
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Chen Hsiang Tseng
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Sander Begeer
- Section Clinical Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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226
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The Role of Child Problem Behaviors in Autism Spectrum Symptoms and Parenting Stress: A Primary School-Based Study. J Autism Dev Disord 2019; 49:857-870. [PMID: 30367345 DOI: 10.1007/s10803-018-3791-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Parents of children with autism spectrum disorders (ASD) reported higher stress than those of typically developing children. The role of child problem behaviors in the relationship between autism spectrum symptoms and parenting stress is little known. A total of 731 parents of 177 children with ASD and 554 typically developing children in primary schools (6-11 years old) completed an ASD screening survey containing measures of parenting stress and child problem behaviors. While autism spectrum symptoms were positively associated with parenting stress, the relationship was mediated by child problem behaviors. Results suggest neither the severity of autism spectrum symptoms nor knowledge of ASD diagnosis was a primary source of parenting stress. A hypothesized path model was tested using structural equation modeling.
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227
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Lecavalier L, Pan X, Smith T, Handen BL, Arnold LE, Silverman L, Tumuluru RV, Hollway J, Aman MG. Parent Stress in a Randomized Clinical Trial of Atomoxetine and Parent Training for Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:980-987. [PMID: 29022125 DOI: 10.1007/s10803-017-3345-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We previously reported a 2 × 2 randomized clinical trial of atomoxetine (ATX) and parent training (PT) for attention deficit hyperactivity disorder (ADHD) symptoms and behavioral noncompliance in 128 children with autism spectrum disorder, ages 5-14 years. Children were randomized to one of four conditions: ATX alone, placebo alone, ATX + PT, or PT + placebo. Both ATX and PT improved some indices of ADHD and behavioral compliance. In this report, we describe parent stress over time and across conditions. All four treatments improved parent self-rated stress from baseline to week 10. However, there were no statistically significant differences between treatment groups. Significantly more improvement in parent stress scores was observed for clinical responders than non-responders. ClinicalTrials.gov Title: Atomoxetine, Placebo and Parent Management Training in Autism (Strattera) ClinicalTrials.gov Identifier: NCT00844753.
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Affiliation(s)
- Luc Lecavalier
- Nisonger Center and Department of Psychology, Ohio State University, 371D McCampbell Hall, 1581 Dodd Dr., Columbus, OH, 43210, USA.
| | - Xueliang Pan
- Center for Biostatistics, Department of Biomedical Informatics, Ohio State University, 371D McCampbell Hall, 1581 Dodd Dr., Columbus, OH, 43210, USA
| | - Tristram Smith
- University of Rochester Medical Center (URMC), 601 Elmwood Ave, Box 671, Rochester, NY, 14642, USA
| | - Benjamin L Handen
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA, 15213, USA
| | - L Eugene Arnold
- Nisonger Center and Department of Psychiatry, Ohio State University, 285B McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - Laura Silverman
- University of Rochester Medical Center (URMC), 601 Elmwood Ave, Box 671, Rochester, NY, 14642, USA
| | - Rameshwari V Tumuluru
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA, 15213, USA
| | - Jill Hollway
- Nisonger Center and Department of Psychiatry, Ohio State University, 285B McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - Michael G Aman
- Nisonger Center and Department of Psychology, Ohio State University, 371D McCampbell Hall, 1581 Dodd Dr., Columbus, OH, 43210, USA
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228
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Iadarola S, Levato L, Harrison B, Smith T, Lecavalier L, Johnson C, Swiezy N, Bearss K, Scahill L. Teaching Parents Behavioral Strategies for Autism Spectrum Disorder (ASD): Effects on Stress, Strain, and Competence. J Autism Dev Disord 2019; 48:1031-1040. [PMID: 28988339 DOI: 10.1007/s10803-017-3339-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report on parent outcomes from a randomized clinical trial of parent training (PT) versus psychoeducation (PEP) in 180 children with autism spectrum disorder (ASD) and disruptive behavior. We compare the impact of PT and PEP on parent outcomes: Parenting Stress Index (PSI), Parent Sense of Competence (PSOC), and Caregiver Strain Questionnaire (CGSQ). Mixed-effects linear models evaluated differences at weeks 12 and 24, controlling for baseline scores. Parents in PT reported greater improvement than PEP on the PSOC (ES = 0.34), CGSQ (ES = 0.50), and difficult child subdomain of the PSI (ES = 0.44). This is the largest trial assessing PT in ASD on parent outcomes. PT reduces disruptive behavior in children, and improves parental competence while reducing parental stress and parental strain.
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Affiliation(s)
- Suzannah Iadarola
- University of Rochester Medical Center, Rochester, NY, USA. .,Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Avenue, Box 671, Rochester, NY, 14642, USA.
| | - Lynne Levato
- University of Rochester Medical Center, Rochester, NY, USA
| | - Bryan Harrison
- University of Rochester Medical Center, Rochester, NY, USA
| | - Tristram Smith
- University of Rochester Medical Center, Rochester, NY, USA
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229
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Child Autism Spectrum Disorder Traits and Parenting Stress: The Utility of Using a Physiological Measure of Parental Stress. J Autism Dev Disord 2019; 48:1081-1091. [PMID: 29164443 DOI: 10.1007/s10803-017-3397-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Caregivers of children with autism spectrum disorder (ASD) report greater stress due to unique parenting demands (e.g.; Estes et al. in Brain Dev 35(2):133-138, 2013). Stress is often studied through self-report and has not been extensively studied using physiological measures. This study compared parenting stress in mothers of children with and without ASD traits. Twenty-seven mother-child dyads participated in an interaction task while measuring mother's heart rate variability (HRV) and mothers self-reported stress levels. Results demonstrated that while self-report and physiological stress measures were not correlated, ASD symptomology did account for HRV change score (i.e., more severe ASD symptoms were positively related to HRV change). This may reflect an atypical coping response. Implications for using physiological indicators for studying parenting stress are explored.
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230
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Tan VXL, Simmonds JG. Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:759-769. [PMID: 29196865 DOI: 10.1007/s10803-017-3399-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using Interpretative phenomenological analysis. Four super-ordinate themes emerged from the analysis: (1) child's improved self-concept and enhanced emotional well-being, (2) child's improved self-regulatory ability, (3) social benefits for the child, and (4) unexpected outcomes. EAI was perceived by the parents as having several levels of psychosocial benefits for their children. These benefits may also extend to parents and family through ecopsychological and "flow on" effects associated with the children's involvement in EAI programs.
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Affiliation(s)
- Vanessa Xue-Ling Tan
- Psychology Programs, Faculty of Education, Monash University, Melbourne, VIC, Australia
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231
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Parenting behavior and the development of children with autism spectrum disorder. Compr Psychiatry 2019; 90:21-29. [PMID: 30658339 DOI: 10.1016/j.comppsych.2018.11.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental disorders in which multiple genetic and environmental factors play roles. Symptoms of deficits in social communication and restrictive, repetitive behavioral patterns emerge early in a child's development. While parents do not cause these difficulties, impairments in social relatedness can strain parent child interactions and parental stress can have negative transactional effects that impede children development. Conversely, as with typically developing children, parental behavior can also enhance development in ASD and parents play a role in many interventions. In this review we examine parental contributions to the development of children with ASD, focusing on social communication and emotion regulation. We address parent and family characteristics that may impede development so they can be identified in families and interventions developed to target them.
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232
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Lavelle TA, Weinstein MC, Newhouse JP, Munir K, Kuhlthau KA, Prosser LA. Parent Preferences for Health Outcomes Associated with Autism Spectrum Disorders. PHARMACOECONOMICS 2019; 37:541-551. [PMID: 30895565 PMCID: PMC6469598 DOI: 10.1007/s40273-019-00783-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Few studies have used preference-based quality-of-life outcomes to assess how autism spectrum disorders (ASDs) affect children and parents, and none have examined variation by ASD severity. OBJECTIVE Our objective was to derive parent valuations of child and parent health associated with varying ASD severity levels. METHODS Parents of children aged 3-17 years with and without ASD were selected from a nationally representative research panel to complete a survey. We asked parents time trade-off (TTO) questions to value their own and their child's current health. Parents of children with ASD were asked to report the severity of their child's core ASD symptoms. We calculated utility values from each TTO amount, and used a two-part regression model to estimate the change in parent-reported child health utility, as well as parent health utility, associated with ASD diagnosis and increasing symptom severity, controlling for respondent and child characteristics. RESULTS Sixty-nine percent of parents responded (final sample size was 135 in the ASD group and 120 in the comparison group). In adjusted analyses, there was a 0.12 (95% confidence interval [CI] 0.03-0.21) decrease in the parent-reported health utility of children with ASD, a 15% decrease from the mean health utility of children without ASD. On average, having a child with ASD was not significantly associated with a decrease in parent health utility, but there was a 0.14 (95% CI 0.01-0.26) reduction in health utility among parents of children with severe ASD, a 15% decrease from the comparison group mean. CONCLUSIONS Overall, ASD had a significant impact on parent-reported child health utility, and the health utility of parents of children with severe ASD.
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Affiliation(s)
- Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
- Tufts University School of Medicine, Boston, MA, USA.
| | - Milton C Weinstein
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joseph P Newhouse
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Kennedy School, Cambridge, MA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Kerim Munir
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Karen A Kuhlthau
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Lisa A Prosser
- Department of Pediatrics and Communicable Diseases, Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, MI, USA
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233
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Al Khateeb JM, Kaczmarek L, Al Hadidi MS. Parents’ perceptions of raising children with autism spectrum disorders in the United States and Arab countries: A comparative review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1645-1654. [DOI: 10.1177/1362361319833929] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Four databases were searched to identify studies published by Arab researchers on parents’ perceptions of autism spectrum disorder and studies conducted by US researchers and published in systematic reviews of this topic. The electronic search resulted in 14 studies published by Arab researchers and 55 studies published by US researchers. The results showed that autism spectrum disorder has many of the same effects on Arab and American families. Six major areas were identified in the results. Financial difficulties associated with raising children with autism spectrum disorder were mentioned more in Arab studies than in US studies. Arab studies had more emphasis on gender than US studies. The results related to quality of life of parents of children with autism spectrum disorder in Arab studies were equivocal. US studies included comparisons with families without a child with autism spectrum disorder, and addressed factors that were associated with quality of life indicators. More health, educational, and social services were available in United States than in Arab countries, but some frustration was reported by US parents in obtaining appropriate services in some studies. A higher percentage of Arab studies mentioned the role of religious faith than US studies. Finally, social stigma was evidenced in both cultures, but not much research was available.
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234
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Mathew NE, Burton KLO, Schierbeek A, Črnčec R, Walter A, Eapen V. Parenting preschoolers with autism: Socioeconomic influences on wellbeing and sense of competence. World J Psychiatry 2019; 9:30-46. [PMID: 30915270 PMCID: PMC6422881 DOI: 10.5498/wjp.v9.i2.30] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 02/05/2019] [Accepted: 02/19/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Previous research suggests that parents raising a child with autism experience higher levels of psychological distress than parents of typically developing children and parents of children with other developmental disorders. Little is known, however, about the intersection between the effects of socioeconomic status (SES) on the wellbeing and sense of parental competency of parents of pre-schoolers with autism and how it relates to child symptom severity.
AIM To examine the relationship between their child’s symptom severity, SES, as measured by neighbourhood advantage and occupational status, on the psychological wellbeing and perceived parenting competence among parents of preschoolers with autism.
METHODS Parents of 117 preschool-aged children with a diagnosis of autism spectrum disorder (ASD), 107 mothers and 54 fathers, completed questionnaires about their child’s symptoms of ASD and functioning, their own perceptions of their wellbeing and parental competence on entry to an early intervention program in Sydney, Australia. Parents also provided demographic information pertaining to their occupation, level of education attained and address (postcode). All children were also assessed for their severity of symptoms using the Autism Diagnostic Observation Schedule. The Australian Socioeconomic Index of occupational status as a measure of familial SES and the Index of Relative Socio-economic Advantage and Disadvantage as a measure of neighbourhood advantage were used to examine the impact of SES on parental sense of competence and wellbeing.
RESULTS Compared to normative populations, both mothers and fathers in our sample reported significantly higher levels of parenting sense of efficacy but lower levels of interest in the parenting role. Mothers also displayed higher levels of satisfaction. Both mothers and fathers displayed higher levels of depression than normative populations with mothers also reporting greater levels of stress and anxiety. Child symptom severity was associated with maternal parenting competency with these relationships amplified among mothers with higher familial SES and who lived in areas of greater neighbourhood advantage. Increased adaptive functioning was associated with better maternal wellbeing, particularly among mothers who lived in areas of greater neighbourhood advantage. Contrastingly, paternal parenting competence was generally not influenced by child adaptive functioning or symptom severity, although for those in higher familial SES brackets, children’s symptom severity and maladaptive symptoms were negatively related to paternal sense of parenting efficacy. There was a trend towards moderate relationships between lower familial SES and greater depression, stress and anxiety among fathers, but no relationship with their child’s ASD symptom severity or functioning.
CONCLUSION SES differentially impacts wellbeing and sense of parenting competence and its relationship to the impact of child symptoms for mothers and fathers of preschoolers with autism.
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Affiliation(s)
- Nisha E Mathew
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
| | - Karen L O Burton
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
| | - Anne Schierbeek
- Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam 1081 HV, The Netherlands
| | - Rudi Črnčec
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
| | - Amelia Walter
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Liverpool NSW 1871, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry South West Sydney and Ingham Institute, South West Sydney Local Health District, Liverpool Hospital, ICAMHS, Mental Health Centre (Level L1), Locked Bag 7103, Liverpool NSW 1871, Australia
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235
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Germone MM, Gabriels RL, Guérin NA, Pan Z, Banks T, O'Haire ME. Animal-assisted activity improves social behaviors in psychiatrically hospitalized youth with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1740-1751. [PMID: 30818971 DOI: 10.1177/1362361319827411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is preliminary research suggesting that animal-assisted activities can improve social interactions of children with autism spectrum disorder. This pilot study sought to investigate the benefits of animal-assisted activities with dogs and psychiatrically hospitalized youth with autism spectrum disorder. Participants were recruited from a specialized inpatient psychiatric hospital unit for youth with autism spectrum disorder and other developmental disabilities. Utilizing a crossover design, participants served as their own control by engaging in two 10-min conditions: an experimental dog and handler interaction (animal-assisted activities) and a novel toy and handler control (control). Of the 142 youth aged 6--8 years screened for participation, 47 completed both conditions. Participants' behavioral data were captured via video and coded using the Observation of Human-Animal Interaction for Research, a tool specifically developed to capture human behavioral interactions in the presence of animals. Overall, social-communication behaviors significantly improved in the animal-assisted activities experimental condition compared to the control condition (p = 0.0001). Specifically, participants in the animal-assisted activities experimental condition displayed more positive emotional facial expressions (p ⩽ 0.0001), talking (p = 0.0408), use of gestures (p = 0.032), and looking at both adults and peers (p ⩽ 0.0001). In addition, a higher frequency of constant motion (p = 0.003) was observed in the animal-assisted activities experimental condition. Results suggest that animal-assisted activities with a dog may promote social-communication behaviors in psychiatrically hospitalized youth with autism spectrum disorder. Given the fact that social and communication behaviors can facilitate treatment engagement for this population, we recommend future studies examine how such improvements can positively affect the psychiatric treatment of this population.
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Affiliation(s)
| | - Robin L Gabriels
- 1 University of Colorado, USA.,2 Children's Hospital Colorado, USA
| | | | - Zhaoxing Pan
- 1 University of Colorado, USA.,2 Children's Hospital Colorado, USA
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236
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Abstract
ABSTRACT Objective: This study analyzes subjective aspects associated with parents’ perception of the changes that have affected their lives since the birth of their child with autism spectrum disorder (ASD). Methods: A qualitative study, using a narrative approach. Semi-structured interviews were conducted with 7 fathers and 16 mothers of children with ASD enrolled in a special needs school in Salvador, Bahia, Brazil. The interviews were transcribed, analytical categories were defined, and data interpreted. Results: Five categories were identified: “Emotional and Health-Related Effects”, “Effects on Daily/Professional and Academic Life”, “Effects on Marital and/or Affective/Sexual Life”, “Effects on Social Life”, “Adaptation Strategies”. The analysis showed that, despite the impacts suffered, social support, professional help can facilitate parents’ adjustment to life changes following the birth of a child with ASD. Conclusion: The physical and emotional demands of living with and parenting a child with ASD are enormous, include changes in social roles and in couples’ social and affective/sexual lives, highlighting the need for parents to receive support from healthcare professionals, particularly mental health professionals. Care strategies need to be implemented for parents, in addition to the healthcare provided to their children, in order to improve the comprehensive care given to the child with ASD.
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237
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Shahabi B, Shahabi R, Foroozandeh E. Analysis of the self-compassion and cognitive flexibility with marital compatibility in parents of children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 66:282-288. [PMID: 34141390 PMCID: PMC7952048 DOI: 10.1080/20473869.2019.1573000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 12/08/2018] [Accepted: 01/12/2019] [Indexed: 06/12/2023]
Abstract
Purpose: Parents of children with autism spectrum disorder (ASD) face many problems in their marital lives. Autism is a developmental disorder, emerging during childhood that affects development across various domains. Studies suggest that autism prevalence rates are increasing, and research shows that parents of children with ASD frequently experience high levels of parenting stress. Marital compatibility is fulfilled when couples have the sense of satisfaction and contentment from each other. This study was done to analyze self-compassion and cognitive flexibility in relation with marital compatibility in parents having children with ASD. Methods: A sample size with 100 married couples, who referred to autism centers, was selected after clinical interviews. The research tools included structural clinical interview (DSM SCID), self-compassion scales questionnaire, cognitive flexibility inventory questionnaire, and marital compatibility test questionnaire, which were completed by the participants. Results: The research is a correlational descriptive study. Data analysis was done by the path analysis method. The findings showed that there was a significant relation between self-compassion, cognitive flexibility, and marital compatibility. Conclusions: In this study, it could be concluded that compassion via flexibility can have indirect positive effects on marital compatibility as two features of self-compassion and cognitive flexibility can help parents of children with ASD to be more compatible and flexible in their marital lives.
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Affiliation(s)
- Bahareh Shahabi
- Department of Psychology, Islamic Azad University Science and Research Branch of Tehran, Tehran, Iran
| | - Rana Shahabi
- Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Foroozandeh
- Department of Psychology, Isfahan (Naein) Branch, Islamic Azad University, Isfahan, Iran
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238
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A Systematic Network of Autism Primary Care Services (SYNAPSE): A Model of Coproduction for the Management of Autism Spectrum Disorder. J Autism Dev Disord 2019; 50:1847-1853. [DOI: 10.1007/s10803-019-03922-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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239
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Guan K, Lau AS, Zhang A, Chlebowski C, Haine-Schlagel R, Brookman-Frazee L. In-Session Caregiver Behaviors during Evidence-Based Intervention Delivery for Children with ASD in Community Mental Health Services. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2019; 4:55-71. [PMID: 31263772 PMCID: PMC6602542 DOI: 10.1080/23794925.2019.1565500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
An Individualized Mental Health Intervention for ASD, ("AIM HI"), is a collaborative, caregiver-mediated and child-directed intervention for reducing challenging behaviors in children with autism spectrum disorder developed for delivery in community mental health programs. Using observational data from AIM HI sessions, the present study characterized the occurrence of two types of in-session caregiver behaviors: expressed concerns (i.e., expressing concerns about treatment strategies; expressing difficulty using skills; expressing difficulty completing homework) and participation engagement (i.e., asking questions; participating in session activities; showing commitment to therapy). Further analyses examined cultural differences in caregiver behaviors and associations between caregiver behaviors and clinician adherence. Participants included 39 caregiver-clinician dyads enrolled in a community effectiveness trial of AIM HI. Video recordings from 107 sessions during the first two months of treatment were coded for in-session caregiver behaviors and clinician adherence. Results indicated that expressed concerns were observed in 47% of sessions. When controlling for household income, Latinx caregivers were rated lower for expressing concerns about treatment strategies and demonstrated lower participation engagement behaviors in session compared with non-Latinx White caregivers, suggesting that cultural factors may impact verbal engagement in sessions. Finally, expressing concerns about treatment strategies, expressing difficulty using skills, and participation engagement were positively associated with clinician adherence. Findings suggest that some expressed concerns and participation engagement behaviors may be indicators of positive caregiver engagement in the context of a collaborative intervention, and lower levels of such caregiver engagement may actually impede clinicians' delivery of intensive evidence-based intervention in routine care.
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Affiliation(s)
- Karen Guan
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095 U.S.A
| | - Anna S. Lau
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095 U.S.A
| | - Aimee Zhang
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095 U.S.A
| | - Colby Chlebowski
- Department of Psychiatry, University of California, San Diego
- Child and Adolescent Services Research Center, 3020 Children’s Way, San Diego, CA 92123 U.S.A
| | - Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University
- Child and Adolescent Services Research Center, 3020 Children’s Way, San Diego, CA 92123 U.S.A
| | - Lauren Brookman-Frazee
- Department of Psychiatry, University of California, San Diego
- Child and Adolescent Services Research Center, 3020 Children’s Way, San Diego, CA 92123 U.S.A
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240
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Zhou Y, Yin H, Wang M, Wang J. The effect of family-focused psychoeducational therapy for autism spectrum disorder children's parents on parenting self-efficacy and emotion. Arch Psychiatr Nurs 2019; 33:17-22. [PMID: 30663619 DOI: 10.1016/j.apnu.2018.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/17/2018] [Accepted: 08/04/2018] [Indexed: 11/18/2022]
Abstract
The purpose of this pilot study was to design, implement, and evaluate the family-focused psychoeducational therapy (FFPT) for autism spectrum disorder (ASD) family. In Phase I, 64 parents of ASD children (ASD-group) and 63 parents of typically development children (TD-group) were invited to investigate parenting self-efficacy and emotion at baseline. In Phase II, the 4-week of FFPT was offered for the ASD-group. Date was collected at baseline, post-intervention and one-month follow-up, using the parental self-efficacy, Self-Rating Anxiety Scale and Self-Rating Depression Scale. The results showed that ASD-group significantly lower levels of parenting self-efficacy and worse emotion than TD-group (p < 0.05); And after attending the program, ASD-group had significant improvements for all outcome measures and these changes maintained over a period of time (p < 0.05). This preliminary study suggests that the FFPT may effectively improve parenting self-efficacy, reduce anxiety and depression for parents of children with ASD.
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Affiliation(s)
- Yating Zhou
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Huaying Yin
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
| | - Minjian Wang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Juan Wang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
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241
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"I Would Like for My Child to be Happy with His Life": Parental Hopes for Their Children with ASD Across the Lifespan. J Autism Dev Disord 2019; 49:2049-2068. [PMID: 30689082 DOI: 10.1007/s10803-019-03882-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this project was to understand the hopes of parents with children with ASD. Particularly understudied are the hopes parents have for long-term outcomes for their child. A cross-sectional focus group design was used and six focus groups were completed. These groups included parents of (1) preschool aged children who were recently diagnosed, (2) children in early elementary school, (3) children in later elementary school, (4) children in middle school, (5) children in high school, and (6) children who are adults with ASD. Results indicated 77.4% of the data were devoted to hopes for the children's independence, happiness, and skill improvement; increased authentic socially significant relationships; and future employment.
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242
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The Role of Choice and Control in the Impact of Autism Waiver Services on Family Quality of Life and Child Progress. J Autism Dev Disord 2019; 49:2035-2048. [DOI: 10.1007/s10803-019-03886-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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243
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Shochet IM, Saggers BR, Carrington SB, Orr JA, Wurfl AM, Duncan BM. A Strength-Focused Parenting Intervention May Be a Valuable Augmentation to a Depression Prevention Focus for Adolescents with Autism. J Autism Dev Disord 2019; 49:2080-2100. [DOI: 10.1007/s10803-019-03893-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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244
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Zhang A, Li J, Zhang Y, Jin X, Ma J. Epilepsy and Autism Spectrum Disorder: An Epidemiological Study in Shanghai, China. Front Psychiatry 2019; 10:658. [PMID: 31572239 PMCID: PMC6751887 DOI: 10.3389/fpsyt.2019.00658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/14/2019] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disease that may involve various brain abnormalities. However, there are few large epidemiological studies on the relation between epilepsy and ASD in terms of different genders and ages. This study aimed to evaluate the relation between epilepsy and ASD based on 74,251 Chinese children aged 3-12 years who were recruited from kindergartens and primary schools in China. ASD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V), and verification of epilepsy was based on medical records. The enrolled children diagnosed with ASD were examined by magnetic resonance imaging (MRI) and took genetic tests to rule out other neurological and congenital diseases. The raw odds ratio (OR) was 60.53 [95% confidence interval (CI) = 37.80-96.92, P < 0.01] for epilepsy and ASD, and the adjusted OR was 38.99 (95% CI = 20.70-73.41, P < 0.01) after controlling for the confounders. Moreover, the adjusted OR was significantly higher in girls (OR = 45.26, 95% CI = 16.42-124.76, P < 0.01) than in boys (OR = 32.64, 95% CI = 14.33-74.34, P < 0.01). Among children with younger age, the adjusted OR was the highest (OR = 75.12, 95% CI = 22.80-247.48.16, P < 0.01). These findings suggest that epilepsy might be closely linked to the development of ASD, especially for early-onset epilepsy and among girls.
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Affiliation(s)
- Anyi Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Li
- Department of Integrative Medicine on Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingming Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Ma
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MOE-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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245
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Lee GK, Shivers CM. Factors that affect the physical and mental health of caregivers of school-age children and transitioning young adults with autism spectrum disorder. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:622-634. [PMID: 30575246 DOI: 10.1111/jar.12556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although studies have examined quality of life (QOL) among family caregivers of individuals with autism spectrum disorder (ASD), little is known about potential differences in QOL based on the age of the individual with ASD, particularly in relation to caregivers' needs, beliefs and coping mechanisms. METHOD This study investigated 132 caregivers of school-age children and 61 caregivers of transitioning young adults with ASD on measures of caregiving, strain, coping, family needs and QOL. RESULTS The results indicated that there were no significant differences in QOL based on the age of the individuals with ASD, although parents of children reported significantly more caregiving behaviours, with coping, internalized strain and health information needs predicted mental health QOL. DISCUSSION Age of the individual with ASD was not significantly related to caregivers' QOL. More research is needed to determine independent predictors of caregiver QOL across the lifespan.
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Affiliation(s)
- Gloria K Lee
- Department of Counseling, Educational Psychology & Special Education, Michigan State University, East Lansing, Michigan
| | - Carolyn M Shivers
- Department of Human Development, Virginia Tech, Blacksburg, Virginia
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246
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Rabin SJ, Bamberger E, Mor-Snir I, Feldman R, Golan O. Parent-Adolescent Reciprocity in a Conflictual Situation Predicts Peer Interaction in Adolescents With ASD. Autism Res 2018; 12:263-273. [DOI: 10.1002/aur.2047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/21/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Shai Joseph Rabin
- Department of Psychology, Faculty of Social Sciences; Bar-Ilan University; Ramat Gan Israel
| | - Esther Bamberger
- Interdisciplinary Center, Baruch Ivcher School of Psychology; Herzliya Israel
| | - Irit Mor-Snir
- Association for Children at Risk; Givat-Shmuel Israel
| | - Ruth Feldman
- Interdisciplinary Center, Center for Developmental Social Neuroscience Baruch Ivcher School of Psychology; Herzliya Israel
| | - Ofer Golan
- Department of Psychology, Faculty of Social Sciences; Bar-Ilan University; Ramat Gan Israel
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247
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Johnston D, Egermann H, Kearney G. Innovative computer technology in music-based interventions for individuals with autism moving beyond traditional interactive music therapy techniques. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1554773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Daniel Johnston
- Communications & Signal Processing Research Group, Department of Electronic Engineering, University of York, York, UK
| | - Hauke Egermann
- York Music Psychology Group, Music Science and Technology Research Cluster, Department of Music, University of York, York, UK
| | - Gavin Kearney
- Communications & Signal Processing Research Group, Department of Electronic Engineering, University of York, York, UK
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248
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The effect of having a child with ADHD or ASD on family separation. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1391-1399. [PMID: 30155559 DOI: 10.1007/s00127-018-1585-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The primary aim of this study was to estimate the risk of parental separation associated with having a child with ADHD or ASD when controlling for a large range of known risk factors for parental separation using Danish registries. METHODS The study included all children with ADHD or ASD born between 1990 and 1998 in Denmark and a sex and age matched random sample of children from the background population. We followed these children and their parents from birth until the child's 25th birthday, parental separation or December 31, 2015, whichever came first. Data were analyzed using Cox Proportional Hazard models by estimating hazard ratios (HR) and 95% confidence intervals. Models were adjusted for a range of child, parental, and family variables. RESULTS The study included the parents of 12,916 children with ADHD, 7496 children with ASD and 18,423 controls. The study found that, even after controlling for a range of potential risk factors, having a child with either ADHD (HR = 1.8, 95% CI 1.6-2.0) or ASD (HR = 1.2, 95% CI 1.1-1.3) significantly increased parents' risk of separating compared with non-affected families. Other factors associated with parental separation were parental imprisonment, parental psychopathology, low parental education level, low household income and living in a larger city. CONCLUSION Parents of children diagnosed with ADHD or ASD were more likely to separate than control parents. It is important to improve our knowledge about the particular characteristics of families at risk of separating to prevent distress for the families and their child.
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249
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Bekhet AK, Garnier-Villarreal M. Depression, positive thinking, personal and social resourcefulness among caregivers of persons with autism spectrum disorders. Arch Psychiatr Nurs 2018; 32:823-827. [PMID: 30454623 DOI: 10.1016/j.apnu.2018.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/25/2018] [Accepted: 06/02/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Abir K Bekhet
- Marquette University College of Nursing, United States.
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250
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Schwartz J, Huntington N, Toomey M, Laverdiere M, Bevans K, Blum N, Bridgemohan C. Measuring the involvement in family life of children with autism spectrum disorder: A DBPNet study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:18-27. [PMID: 30092382 DOI: 10.1016/j.ridd.2018.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 07/23/2018] [Accepted: 07/28/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Children with Autism Spectrum Disorder (ASD) have social and communication deficits that impair their involvement in family life. No measures of child involvement in the family have been validated for the ASD population. AIM To evaluate the validity of a measure of Family Involvement (FI) of children ages 5-12 with ASD. METHOD Parents of children ages 5-12 with ASD (n = 114) completed FI items from the PROMIS® pediatric Family Relationships item bank in computerized adaptive testing (CAT) format, as well as measures of ASD symptom burden, parenting stress, and parental depression. Medical record review provided child intelligence or developmental quotient. A reference sample (n = 236) closely matching the ASD sample in age and gender was created from the national standardization sample, and underwent a simulated CAT. RESULTS The CAT precisely and efficiently measured parent-reported FI of children with ASD. Average FI scores were lower among children with ASD (M = 46.3, SD = 7.1) than children in the reference sample (M = 52.5, SD = 9.1). A "dose response" decrease in FI was observed as ASD severity increased. Increased parenting stress was associated with lower FI. No relationship between FI and child IQ was found. CONCLUSION The FI items captured FI among children ages 5-12 with ASD with acceptable precision. Reduced FI among children with ASD, particularly those with higher symptom severity, suggests validity of the items in this population.
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Affiliation(s)
- Justin Schwartz
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Noelle Huntington
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Marisa Toomey
- Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Michele Laverdiere
- Department of Pediatrics, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Bronx, NY 10461, USA
| | - Katherine Bevans
- Department of Pediatrics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Nathan Blum
- Department of Pediatrics, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Bronx, NY 10461, USA
| | - Carolyn Bridgemohan
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
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