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Li H, Dodd-Butera T, Beaman ML, Burtea R. Immediate Caregiving Environment of Young Children with Autism: Findings from the U.S. National Survey of Children's Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:12. [PMID: 38276800 PMCID: PMC10815337 DOI: 10.3390/ijerph21010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disability that negatively affects children's learning, motor behavior, social communication, and interaction. It was estimated that, in 2020, 1 in 36 children aged 8 years in the United States had ASD. Caring for children with ASD might exert significant psychological and emotional distress on parents. Receiving parental emotional support and fostering positive parent-child interactions at home have been identified as beneficial for the immediate caregiving environment for children with ASD. The current secondary analysis of the 2019-2020 National Survey of Children's Health examined parent-child interactions and accessible sources of emotional support for parents caring for 3-5-year-old children diagnosed with ASD (N = 243). Children with the following characteristics had higher odds of having ASD: male gender; having no private insurance or uninsured; and having less than excellent general health. Among parents, higher odds of caring for children with ASD were associated with accessing emotional support from various sources, especially from healthcare professionals and peers, and spending more time telling stories and/or singing to their children. Given these significant health disparities, educational interventions and strategies are needed to foster a positive home caregiving environment for young children with ASD, including equitable access to parent resources.
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Affiliation(s)
- Hong Li
- Department of Doctoral Studies, Institute of Health Research, School of Nursing, Azusa Pacific University, 606 E Huntington Dr., Room 235, Monrovia, CA 91016, USA
| | - Teresa Dodd-Butera
- Departments of Public Health and Doctoral Studies, Institute of Health Research, School of Nursing, Azusa Pacific University, San Diego, CA 92108, USA;
| | - Margaret L. Beaman
- Department of Nursing, California State University, San Bernardino, CA 92407, USA
| | - Rebecca Burtea
- Department of Mathematics, Physics, and Statistics, Azusa Pacific University, Azusa, CA 91702, USA;
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Dimachkie Nunnally A, Factor RS, Sturm A, Valluripalli Soorya L, Wainer A, Taylor S, Ponzini M, Abbeduto L, Gulsrud AC. Examining indicators of psychosocial risk and resilience in parents of autistic children. Front Behav Neurosci 2023; 17:1102516. [PMID: 37255619 PMCID: PMC10226532 DOI: 10.3389/fnbeh.2023.1102516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Background Parents of autistic children experience increased levels of caregiver strain and adverse mental health outcomes, even in comparison to parents of children with other neurodevelopmental disabilities. Previous studies have largely attributed these increased levels of mental health concerns to their child behavioral concerns and autism symptomatology, but less attention has been given to other potential child factors, such as child adaptive functioning. Additionally, little is known about potential protective factors, such as parents' emotion regulation (ER) abilities, that may ameliorate the experience of caregiver strain, anxiety, and depression. Objective The current study examined the impact of child characteristics (restricted and repetitive behaviors, adaptive functioning and behavioral concerns) on parent mental health outcomes (caregiver strain, anxiety, depression and wellbeing). Additionally, we explore parents' ER abilities as a moderator of the impact of child characteristic on parents' mental health outcomes. Results Results of linear mixed effect models indicated a significant relationship between parents' ER abilities and all four parent outcomes. Additionally, children's adaptive functioning abilities and repetitive behaviors (RRBs) were significant predictors of caregiving strain. Parents' ER abilities were a significant moderator of the effect of children's repetitive behaviors and adaptive functioning challenges on caregiver strain, such that better ER abilities mitigated the impact of child clinical factors on caregiver strain. Finally, a significant difference was detected for mothers' and fathers' mental health, with mothers reporting higher caregiver strain, and more symptoms of anxiety and depression than did fathers. Conclusion This study leveraged a large sample of autistic children and their biological parents to examine the relationship between children's clinical characteristics and parents' psychological wellbeing. Results indicate that, although parents of autistic children do experience high rates of internalizing mental health concerns that relate to child adaptive functioning and RRBs, parent ER abilities act as a protective factor against parents' adverse mental health outcomes. Further, mothers in our sample reported significantly higher rates of depression, anxiety, and caregiver strain, as compared with fathers.
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Affiliation(s)
- Amanda Dimachkie Nunnally
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Reina S. Factor
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexandra Sturm
- Department of Psychological Science, Loyola Marymount University, Los Angeles, CA, United States
| | - Latha Valluripalli Soorya
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Allison Wainer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Sandra Taylor
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Matthew Ponzini
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Amanda C. Gulsrud
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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3
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Han ZR, Yan J, Yang X, Guo M, West KB, Suveg C, Wang H. The impacts of anxiety and depressive symptoms on emotional processing in children and their parents: an event-related potential study. Child Adolesc Psychiatry Ment Health 2023; 17:58. [PMID: 37170287 PMCID: PMC10176778 DOI: 10.1186/s13034-023-00610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/05/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Anxiety and depressive symptoms are associated with dysregulated emotional processing. However, less is known about the intra-personal and inter-personal impacts of anxiety and depressive symptoms on emotional processing in children and their parents. METHODS In a community sample of 36 parent-child dyads (total N = 72), the current study investigated the intra- and inter-personal effects of anxiety and depressive symptoms on the child's and the parent's neurophysiological responses to emotional (i.e., pleasant and unpleasant) stimuli, indexed by the late positive potential (LPP). RESULTS The results indicated that children's anxiety symptoms were correlated with their enhanced LPPs to pleasant versus neutral pictures. Additionally, children's depressive symptoms related to their increased LPPs to unpleasant stimuli. Importantly, children's anxiety symptoms were associated with their parents' increased LPPs to both unpleasant and pleasant information. CONCLUSIONS These findings suggest that anxiety symptoms in community children were related to their own as well as their parents' emotional processing. The findings contribute to cognitive and family models of anxiety and depression and further highlight the potential role of dyadic interventions for the alleviation of impairing symptoms in children and their caregivers.
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Affiliation(s)
- Zhuo Rachel Han
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Julia Yan
- Department of Human Development and Family Studies, The University of Tennessee, Knoxville, TN, USA
| | - Xuan Yang
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Mingjia Guo
- School of Humanities and Social Sciences, Beijing Institute of Technology, Beijing, China
| | | | - Cynthia Suveg
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Hui Wang
- School of Applied Psychology, Beijing Normal University at Zhuhai, No. 18 Jinfeng Road, Zhuhai, 519087, China.
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Martinez VC, Turnage D. Social Support and Parenting Stress in Hispanic Parents of Children with Autism Spectrum Disorder. Issues Ment Health Nurs 2022; 43:1030-1040. [PMID: 35849744 DOI: 10.1080/01612840.2022.2100949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this integrative review is to synthesize the literature examining the relationship between parenting stress and social support in Hispanic parents of children with autism spectrum disorder (ASD). A database search of studies that evaluated parenting stress and social support in this population was conducted. Fourteen studies met inclusion criteria. Despite high stress levels, both informal and formal social supports improved parenting stress among Hispanic families. Few studies evaluated culturally sensitive social support interventions. With the increasing prevalence of ASD, the development of culturally sensitive social support interventions is necessary to promote the well-being of Hispanic families.
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Affiliation(s)
- Valerie C Martinez
- College of Nursing, University of Central Florida, Orlando, Florida, USA
| | - Dawn Turnage
- College of Nursing, University of Central Florida, Orlando, Florida, USA
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The Association between Parenting Stress, Positive Reappraisal Coping, and Quality of Life in Parents with Autism Spectrum Disorder (ASD) Children: A Systematic Review. Healthcare (Basel) 2021; 10:healthcare10010052. [PMID: 35052216 PMCID: PMC8775364 DOI: 10.3390/healthcare10010052] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/25/2022] Open
Abstract
Parents with autism spectrum disorder (ASD) children generally suffer from poor coping and an impaired quality of life (QoL). This systematic review investigates parenting stress, positive reappraisal coping, and QoL in parents with ASD children. A literature search was carried out for publications written in English on the selected investigation topics using five databases, namely, Scopus, PubMed, Wiley, ScienceDirect Online, and EBSCO. Only studies investigating or measuring parenting stress, positive reappraisal coping, and QoL in ASD were included. Our results indicate that parents with ASD children have high stress levels. This is associated with the ineffective use of coping strategies and a low QoL. Adaptive coping strategies are related to a higher QoL, whereas maladaptive coping techniques are related to a worse QoL. Positive reappraisal coping is negatively correlated to meaningfulness, and it is used by parents to change their daily routines in order to motivate themselves towards new and evolving goals in life. Finally, we found a significant negative correlation between parenting stress, positive reappraisal coping, and the QoL of parents with ASD children. Positive reappraisal coping as a strategy helps parents adapt to stress and was found to be a potential mediatory function between parental stress and QoL.
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Raulston TJ, Kosty D, McIntyre LL. Mindful Parenting, Caregiver Distress, and Conduct Problems in Children With Autism. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:396-408. [PMID: 34428270 DOI: 10.1352/1944-7558-126.5.396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/12/2021] [Indexed: 06/13/2023]
Abstract
Children with autism may display an externalizing problem behavior, which are associated with increased parenting stress and depression in caregivers. Mindful parenting is defined as having a non-judgmental moment-to-moment awareness during caregiver-child interactions. The extant literature is mixed, with some reporting that associations between child problem behavior and parenting stress and depression vary by level of mindful parenting, while others have not found these relations. We sought to extend these explorations. Participants who were caregivers of 75 children with autism spectrum disorder (ASD) ages 5-10, in the Pacific Northwestern region of the United States. Child conduct problems, parenting stress and caregiver depression, and mindful parenting were measured using caregiver-reported measures. Child conduct problems, parenting stress, and caregiver depression, and mindful parenting were all significantly correlated. The association between child conduct problems and parenting stress was significant for caregivers with high and low levels of mindful parenting. In contrast, the association between child conduct problems and caregiver depression was significant only for caregivers with low levels of mindful parenting. Our results suggest that mindful parenting may be a promising protective factor for the well-being of caregivers of children with autism. Implications are discussed.
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Affiliation(s)
| | - Derek Kosty
- Derek Kosty and Laura Lee McIntyre, University of Oregon
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Bullard L, Harvey D, Abbeduto L. Maternal Mental Health and Parenting Stress and Their Relationships to Characteristics of the Child With Fragile X Syndrome. Front Psychiatry 2021; 12:716585. [PMID: 34899411 PMCID: PMC8651564 DOI: 10.3389/fpsyt.2021.716585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/28/2021] [Indexed: 12/31/2022] Open
Abstract
Although previous research supports the notion that characteristics of both the child and the mother impact maternal well-being and parenting stress in mothers of children with FXS, more work is needed in which self-report measures are supplemented by physiological measures of stress and well-being. The inclusion of physiological measures, such as heart rate variability (HRV), may provide a window into the biological origins and consequences of maternal perceptions of their experiences, including the challenges of raising a child with developmental challenges. The proposed project, therefore, involved the collection of multimodal assessment data from mothers and their school-aged children with FXS. Further, given the importance of understanding how mothers of youth with FXS are faring in their everyday environment, the present study collected all data using telehealth procedures and wearable technology. Participants were 20 biological mothers and their children with FXS between the ages of 6 and 11 years. We measured maternal mental health and parenting stress through self-report as well as through HRV as a more objective measure of psychological well-being. We also examined the associations between these variables and child characteristics such as externalizing and internalizing behaviors as well as autism symptomatology. We found significant support for an elevated rate of depressive symptoms in the sample of mothers (35%) and some potential indicators for heightened rates of anxiety (15%) when compared to normed samples and rates in the general population. We also found that the mothers presented with an atypical HRV profile akin to those experiencing depression or chronic stress, although limitations of the present measure suggest the need for additional confirmatory research. Further, we found that child externalizing behaviors were the primary correlates of maternal well-being. These findings contribute to the growing body of literature regarding the unique challenges faced by these mother-child dyads and supports the importance of increasing the availability of services available to these mothers, not only for meeting the needs of their children's development and behavior, but in supporting their own well-being as well.
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Affiliation(s)
- Lauren Bullard
- MIND Institute, UC Davis Health, Sacramento, CA, United States.,Department of Psychiatry and Behavioral Sciences, UC Davis Health, Sacramento, CA, United States
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Leonard Abbeduto
- MIND Institute, UC Davis Health, Sacramento, CA, United States.,Department of Psychiatry and Behavioral Sciences, UC Davis Health, Sacramento, CA, United States
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Maternal Affect During a Challenging Mother-Child Interaction: The Effects of Broad Autism Phenotype and Respiratory Sinus Arrhythmia Reactivity in Mothers of Children With and Without Autism Spectrum Disorder. J Autism Dev Disord 2020; 49:4891-4900. [PMID: 31473950 DOI: 10.1007/s10803-019-04198-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Respiratory sinus arrhythmia (RSA) is proposed to index cognitive and behavioral inflexibility. Broad autism phenotype (BAP) traits are prevalent in family members of children with autism spectrum disorder (ASD). The study investigated whether RSA and BAP traits in mothers of typically developing (TD) children and mothers of children with ASD influence maternal affect. It was hypothesized that these factors would interact to influence mother-child interactions. Twenty-three mother-child dyads participated in a challenging interaction while measuring mother's RSA. Results indicated that mothers of children with ASD show different RSA reactivity than mothers of TD children. Furthermore, preliminary analyses revealed RSA reactivity moderated the relationship between mothers' rigidity and maternal affect during this interaction. Implications for future research and interventions are discussed.
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Salomone E, Settanni M, Ferrara F, Salandin A. The Interplay of Communication Skills, Emotional and Behavioural Problems and Parental Psychological Distress. J Autism Dev Disord 2020; 49:4365-4374. [PMID: 31368058 DOI: 10.1007/s10803-019-04142-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We investigated the mechanism of impact of poor communication skills and emotional and behavioural problems in children with ASD (22-61 months) on parental psychological distress. Participants were dyads enrolled in two pilot intervention studies; the dataset includes cross-sectional data at baseline (N = 82). We postulated an indirect effect of child expressive and receptive communication on parent psychological distress, through child emotional and behavioural problems. The effect of receptive skills on parent psychological distress was fully mediated by child emotional problems: lower receptive skills were associated with higher levels of emotional symptoms, which in turn predicted higher parent psychological distress. Expressive skills did not show either direct or indirect effects. Findings are discussed in light of children's marked 'receptive disadvantage' communication profile.
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Affiliation(s)
- Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Milan, Italy.
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10
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The Effects of Parent Training Programs on the Quality of Life and Stress Levels of Parents Raising a Child with Autism Spectrum Disorder: a Systematic Review of the Literature. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00190-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Frye RE, Vassall S, Kaur G, Lewis C, Karim M, Rossignol D. Emerging biomarkers in autism spectrum disorder: a systematic review. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:792. [PMID: 32042808 DOI: 10.21037/atm.2019.11.53] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Autism spectrum disorder (ASD) affects approximately 2% of children in the United States (US) yet its etiology is unclear and effective treatments are lacking. Therapeutic interventions are most effective if started early in life, yet diagnosis often remains delayed, partly because the diagnosis of ASD is based on identifying abnormal behaviors that may not emerge until the disorder is well established. Biomarkers that identify children at risk during the pre-symptomatic period, assist with early diagnosis, confirm behavioral observations, stratify patients into subgroups, and predict therapeutic response would be a great advance. Here we underwent a systematic review of the literature on ASD to identify promising biomarkers and rated the biomarkers in regards to a Level of Evidence and Grade of Recommendation using the Oxford Centre for Evidence-Based Medicine scale. Biomarkers identified by our review included physiological biomarkers that identify neuroimmune and metabolic abnormalities, neurological biomarkers including abnormalities in brain structure, function and neurophysiology, subtle behavioral biomarkers including atypical development of visual attention, genetic biomarkers and gastrointestinal biomarkers. Biomarkers of ASD may be found prior to birth and after diagnosis and some may predict response to specific treatments. Many promising biomarkers have been developed for ASD. However, many biomarkers are preliminary and need to be validated and their role in the diagnosis and treatment of ASD needs to be defined. It is likely that biomarkers will need to be combined to be effective to identify ASD early and guide treatment.
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Affiliation(s)
- Richard E Frye
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.,Deparment of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Sarah Vassall
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Gurjot Kaur
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Christina Lewis
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Mohammand Karim
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.,Deparment of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA
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Chu SY, Mohd Normal SNSAB, McConnell GE, Tan JS, Joginder Singh SKD. Challenges faced by parents of children with autism spectrum disorder in Malaysia. SPEECH LANGUAGE AND HEARING 2018. [DOI: 10.1080/2050571x.2018.1548678] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shin Ying Chu
- Faculty of Health Sciences, Centre for Rehabilitation & Special Needs, Speech Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Grace E. McConnell
- Department of Communication Sciences and Disorders, Rockhurst University, Kansas City, MO, USA
| | - Joo Siang Tan
- Faculty of Social Sciences and Humanities, School of Education, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Susheel Kaur Dhillon Joginder Singh
- Faculty of Health Sciences, Centre for Rehabilitation & Special Needs, Speech Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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