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Brunt S, Nevill R, Mazurek MO. Associations Among Autism Symptom Domains and Facets of Caregiver Strain. J Autism Dev Disord 2024; 54:1507-1516. [PMID: 36637596 PMCID: PMC10931534 DOI: 10.1007/s10803-022-05885-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 01/14/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) often experience elevated levels of caregiver strain (CGS). Few studies have examined the relationship between core ASD symptoms and each facet of CGS: objective, subjective internalized, and subjective externalized strain. The predictive effect of core and associated features of ASD on CGS facets were investigated, while also exploring the moderating effect of age. Atypical behaviors and behavior problems were the strongest predictors of all types of caregiver strain. For younger children, more repetitive behaviors predicted higher externalized strain, yet the opposite was true for parents of adolescents. Given that caregiver strain impacts parents' service utilization patterns, future research should focus on strategies to support parents in reducing caregiver strain.
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Affiliation(s)
- Sophie Brunt
- University of Virginia, 417 Emmet St. South, 22903, Charlottesville, VA, USA.
| | - Rose Nevill
- University of Virginia, 417 Emmet St. South, 22903, Charlottesville, VA, USA
| | - Micah O Mazurek
- University of Virginia, 417 Emmet St. South, 22903, Charlottesville, VA, USA
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2
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Ben-Sasson A, Podoly TY, Lebowitz ER. The Role of Pediatric Sensory Over-responsivity and Anxiety Symptoms in the Development of Family Accommodations. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01547-4. [PMID: 37219643 DOI: 10.1007/s10578-023-01547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 05/24/2023]
Abstract
Sensory over-responsivity (SOR) is linked with elevated anxiety and reduced family wellbeing. Family accommodation of anxiety relates with greater symptom severity and reduced intervention outcome. This study examined the contribution of child SOR and co-occurring anxiety symptoms to family accommodation and its consequences. Ninety families of typically developing children (ages 4-13 years), completed an online survey including the Sensory Profile 2, Screen for Child Anxiety Related Emotional Disorders (SCARED), and Family Accommodation Sensory Scale (FASENS). FASENS scores include frequency of accommodation, child impact, and family impact.Children with elevated anxiety symptoms had significantly higher sensory and FASENS scores. Stepwise linear regression indicated that only SOR symptoms significantly predicted the frequency of sensory family accommodation, while both SOR and anxiety symptoms predicted the impact of family accommodation upon child and family well-being.Both SOR and anxiety symptoms in children predict the impact of sensory family accommodations on child and family well-being.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Hushi, Haifa, 3498838, Israel.
| | - Tamar Y Podoly
- Oti, Israeli Association for ASD, Reserach Center, Givat Shmuel, Israel
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Eli R Lebowitz
- Child Study Center, Yale University School of Medicine, New Haven, USA
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3
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Griffin ZAM, Boulton KA, Thapa R, DeMayo MM, Ambarchi Z, Thomas E, Pokorski I, Hickie IB, Guastella AJ. Atypical sensory processing features in children with autism, and their relationships with maladaptive behaviors and caregiver strain. Autism Res 2022; 15:1120-1129. [PMID: 35297186 PMCID: PMC9544661 DOI: 10.1002/aur.2700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/05/2023]
Abstract
Atypical sensory processing occurs in up to 97% of children on the autism spectrum. Children who are on the autism spectrum also commonly demonstrate challenging behaviors, and their caregivers report increased levels of strain in daily life. The aim of this study was to explore four sensory processing features; seeking, avoiding, sensitivity, and registration, and their relationships with maladaptive behaviors in children with autism, as well as with caregiver strain. Participants comprised 75 children with autism aged 7–12 years (M = 7.81). Caregivers completed three questionnaire measures examining child sensory processing, maladaptive behaviors, and perceptions of caregiver strain. We found avoiding significantly associated with irritability. Avoiding also displayed the strongest relationship with global caregiver strain. Avoiding and seeking were strongly related to hyperactivity/noncompliance (components of maladaptive behavior). A multiple regression was performed to explore how atypical sensory processing features and maladaptive behaviors together predicted caregiver strain. Together, maladaptive behaviors and sensory features accounted for 58% of the variance in total caregiver strain. The only significant individual predictor of total caregiver strain was sensory avoiding, which uniquely accounted for 5.76% of the variation. The findings suggest that atypical sensory processing is associated with overall caregiver strain, above that explained by maladaptive behaviors. Implications for targeted support for the benefit of the child, parents and family unit are discussed.
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Affiliation(s)
- Zoe A M Griffin
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kelsie A Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Rinku Thapa
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Marilena M DeMayo
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Zahava Ambarchi
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Emma Thomas
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Izabella Pokorski
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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Lindly OJ, Shui AM, Stotts NM, Kuhlthau KA. Caregiver strain among North American parents of children from the Autism Treatment Network Registry Call-Back Study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1460-1476. [PMID: 34657479 PMCID: PMC9012781 DOI: 10.1177/13623613211052108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Caregiver strain is the adverse impact that parents of children with emotional and behavioral issues including autism often experience (e.g. negative consequences of caregiving such as financial strain and social isolation; negative feelings that are internal to the caregiver such as worry and guilt; and negative feelings directed toward the child such as anger or resentment). This study showed that on average caregiver strain did not significantly change in North American parents of children with autism during a 2-year period. Improved caregiver strain was linked to improved child functioning and behavior. Routine assessment of caregiver strain and referral to evidence-based programming and supports may help alleviate some of the burden that families of children with autism commonly experience.
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Affiliation(s)
- Olivia J Lindly
- Northern Arizona University, USA.,Massachusetts General Hospital, USA
| | | | | | - Karen A Kuhlthau
- Massachusetts General Hospital, USA.,Harvard Medical School, USA
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Bradshaw J, Gillespie S, McCracken C, King BH, McCracken JT, Johnson CR, Lecavalier L, Smith T, Swiezy N, Bearss K, Sikich L, Donnelly C, Hollander E, McDougle CJ, Scahill L. Predictors of Caregiver Strain for Parents of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:3039-3049. [PMID: 33151499 PMCID: PMC10860166 DOI: 10.1007/s10803-020-04625-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Parents of children with autism spectrum disorder (ASD) face higher levels of caregiver strain compared to parents of children with other disabilities. This study examined child clinical features that predict high levels of caregiver strain for 374 parents of children with ASD. Caregiver strain was measured using the Caregiver Strain Questionnaire (CGSQ) objective, subjective internalized, and subjective externalized subscales. Confirmatory factor analysis indicated an acceptable fit for the original CGSQ three-factor solution. The strongest child predictors across CGSQ subscales were: disruptive behavior for objective strain, autism severity and disruptive behavior for subjective internalized strain, and oppositional behavior and hyperactivity for subjective externalized strain. Individualized interventions that attend to specific elements of parental strain may reduce strain and improve family wellbeing.
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Affiliation(s)
- Jessica Bradshaw
- University of South Carolina, 1800 Gervais St., Columbia, SC, 29201, USA
| | - Scott Gillespie
- Emory-Children's-Georgia Tech Pediatric Research Alliance, 2015 Uppergate Drive, Atlanta, GA, USA
| | - Courtney McCracken
- Emory-Children's-Georgia Tech Pediatric Research Alliance, 2015 Uppergate Drive, Atlanta, GA, USA
| | - Bryan H King
- Department of Psychiatry, Weill Institute for Neurosciences, Benioff Children's Hospitals, University of California San Francisco, 401 Parnassus Ave., Suite LP 358, San Francisco, CA, 94143-0984, USA
| | - James T McCracken
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Cynthia R Johnson
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, EC-10 Cleveland Clinic, 9501 Euclid Ave, Cleveland, OH, 44195, USA
| | - Luc Lecavalier
- Nisonger Center, Ohio State University, 1581 Dodd Dr #357, Columbus, OH, 43210, USA
| | - Tristram Smith
- University of Rochester Medical Center School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Naomi Swiezy
- Indiana University Riley Hospital for Children, 705 Riley Hospital Dr #4300, Indianapolis, IN, 46202, USA
| | - Karen Bearss
- Seattle Children's Autism Center and Research Institute, 4909 25th Avenue, Northeast, Seattle, Washington, 98105, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA
| | - Linmarie Sikich
- Duke Center for Autism and Brain Development, 2608 Erwin Rd, Suite 300, Durham, NC, 27705, USA
| | - Craig Donnelly
- Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA
| | - Eric Hollander
- Albert Einstein College of Medicine and Psychiatric Research Institute at Montefiore-Einstein, 1225 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Christopher J McDougle
- Lurie Center for Autism, 1 Maguire Rd, Lexington, MA, 02421, USA
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - Lawrence Scahill
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Dr, Atlanta, GA, 30322, USA.
- Marcus Autism Center, 1920 Briarcliff Rd., Atlanta, GA, 30324, USA.
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Gafni-Lachter L, Kailkian J, Korngold-Dvir V, Dahan G, Ben-Sasson A. The association between sensory traits and daily parenting challenges of typical mothers and their children. Br J Occup Ther 2021. [DOI: 10.1177/03080226211031800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Sensory modulation impacts daily family life; however, parents’ sensory traits are rarely considered and analysed together with their child’s. This study aimed to: (1) determine the association between healthy child and mother sensory modulation traits and (2) examine how these traits interact in predicting daily parenting challenges. Method Seventy-three healthy mothers of typically developing 3–6-year-old children completed the Short Sensory Profile, Adult/Adolescent Sensory Profile and Parenting Daily Hassles questionnaires. Mother and child sensory over-responsivity (SOR), under-responsivity (SUR) and seeking traits were entered as predictors of frequency of daily hassles. Results Mother and child’s SOR and SUR traits were significantly associated ( r = .33 and .25, respectively). The frequency of parenting challenges was significantly associated with both mother and child’s sensory seeking ( r = .25 and .26, respectively). A mediation model demonstrated a significant indirect effect of mother SOR on the frequency of daily hassles ( β = .26, p < .05), with the child’s SOR ( β = .33, p < .01), and seeking behaviours ( β = .48, p < .001) mediating this effect. Conclusion Mothers with elevated sensory traits of children with elevated sensory traits are likely to experience higher frequencies of daily parenting burden, even within the typical population. Therapists who wish to practice a developmental and family-centred approach should assess how the mother–child sensory traits interact and how this interaction can influence the family’s well-being.
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Affiliation(s)
| | | | | | - Gil Dahan
- Child Development Center, Nahariya, Israel
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Sadighian MJ, Allen IE, Quanstrom K, Breyer BN, Suskind AM, Baradaran N, Copp HL, Hampson LA. Caregiver Burden Among Those Caring for Patients With Spina Bifida. Urology 2021; 153:339-344. [PMID: 33812880 DOI: 10.1016/j.urology.2021.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/15/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE 1) To identify baseline characteristics of caregivers of school-aged children with spina bifida; 2) To identify independent predictors of caregiver burden in this population. MATERIALS AND METHODS A survey was distributed via Facebook advertising to caregivers of patients with congenital genitourinary anomalies from May to September 2018. Eligible participants (n = 408) entailed English-speaking adults who are involved in the patient's care and attend ≥50% of their medical appointments. Caregiver burden was assessed using the Caregiver Burden Inventory (CBI), where higher scores indicate higher burden. CBI ≥24 indicates need for respite and CBI ≥36 indicates high risk of burnout. Bivariate analyses (t-tests and chi-square tests) were conducted using STATA software. RESULTS Our analysis includes 408 caregivers caring for patients with spina bifida. In our study population, 59.3% of caregivers were in need of respite due to caregiver burden and 26.7% of caregivers were so burdened that they are at risk of burning out (CBI score ≥36). Bivariate analysis showed that caregiver gender and number of tasks performed by the caregiver were significantly associated with risk of burnout (CBI ≥ 36). Multivariable analysis of overall caregiver burden showed increased risk of burnout (CBI ≥ 36) among older caregivers, female caregivers, and those performing more caregiving tasks. CONCLUSION Caregiver burden is common among caregivers of patients with spina bifida, and further research is needed to identify strategies and resources for mitigating caregiver burden.
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Affiliation(s)
- Michael J Sadighian
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Isabelle E Allen
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Kathryn Quanstrom
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; University of Michigan, Ann Arbor, MI
| | - Benjamin N Breyer
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Anne M Suskind
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Nima Baradaran
- Department of Urology, Ohio State University, Columbus, OH
| | - Hillary L Copp
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Lindsay A Hampson
- School of Medicine, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
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Watson SL, Stine F, Tumin D, Stiles KM. Employment and well-being among caregivers of children with autism spectrum disorder. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1810576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sarah L. Watson
- Department of Sociology, East Carolina University, Greenville, NC, USA
| | - Fritz Stine
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Karen M. Stiles
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
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