Perceived Social Support, Normalization, and Subjective Well-Being Among Family Members of a Child with Autism Spectrum Disorder

A Serial Mediation Model of Resilience Among Caregivers of Children With Autism

IMPORTANCE

Resilience has been reported as a vital element against the high burden on caregivers of children with autism. However, the intricate mechanisms underlying the concurrent interplay of positive factors with resilience within this demographic group remain less understood.

OBJECTIVE

To construct a model to verify the sequential mediating influence of hope and gratitude in the relationship between perceived social support and resilience among caregivers of children with autism.

DESIGN

Cross-sectional study.

PARTICIPANTS

A total of 193 caregivers of children with autism in mainland China.

OUTCOMES AND MEASURES

Data were collected using the Herth Hope Index, C-GQ-6 Gratitude Questionnaire, Perceived Social Support Scale, and Resilience Questionnaire for Parents of Children With Special Needs. The hypothesized mediating model was tested with Process 4.0 (Model 6) for SPSS (Version 26.0).

RESULTS

The relationship of perceived social support and resilience was mediated by hope, gratitude, and the hope-gratitude sequence. Hope exhibited a stronger mediation effect, accounting for 26.23% of the total effect.

CONCLUSIONS AND RELEVANCE

The results indicated significant positive correlations between perceived social support, hope, gratitude, and resilience, with perceived social support strongly linked to the other three. This study has important implications for occupational therapy, suggesting strategies for resilience-focused interventions tailored to caregivers of children with autism.

PLAIN-LANGUAGE SUMMARY

Resilience is essential for caregivers of children with autism. Studies show that parents of children with autism report having fewer social supports, reduced quality of life, and heightened mental health challenges, including anxiety, depression, and hopelessness. This research highlights the connections between caregivers' perceived social support, hope, gratitude, and resilience. Addressing caregiver social supports and mental health can enhance caregiver well-being as well as children's participation in meaningful activities. The findings suggest practical implications and insights for occupational therapy practitioners to strengthen and foster caregiver resilience and well-being in the autism community.

Well-being among parents of youth with multiple sclerosis: a preliminary longitudinal study

Background

In 2021, the annual rate of pediatric-onset multiple sclerosis (POMS) in Israel among children was 1.5, and 4.5% among youth aged 14-18, out of a total of 5,000 multiple sclerosis cases nationwide. Children diagnosed with POMS often display various deficiencies across psychological, cognitive, sensory, and physical areas. As such, POMS poses significant challenges for parents' well-being, with heightened emotional, financial, and physical strains linked to both the immediate and long-term care requirements of their children. In this preliminary study, we examined changes over three time-points in two measures of well-being: satisfaction with life and psychological distress. In addition, the role of perceived social support (PSS) and coping flexibility was examined through a multilevel causal mediation model which suggested that PSS 1 month post-diagnosis would predict coping flexibility at 6 months post-diagnosis, which in turn would predict parents' life satisfaction and psychological distress at 12 months post-diagnosis.

Methods

The research was conducted at a tertiary university-affiliated children's hospital in central Israel. Preliminary data were obtained from 36 parents at three times-points. Participants provided demographic information and filled out the following standardized self-report questionnaires: the Diener's Satisfaction with Life Scale, Kessler's inventory for measuring psychological distress (K6), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Perceived Ability to Cope with Trauma Scale (PACT) for measuring coping flexibility.

Results

Over time (12 months), parents reported stable levels of PSS, coping flexibility, satisfaction with life, and psychological distress. In addition, mothers reported significantly greater PSS from friends than did fathers. Regarding the causal mediation model, greater PSS from friends at T1 was significantly associated with an increase in coping flexibility from T1 to T2. In turn, an increase in coping flexibility was associated with a decrease in psychological distress from T1 to T3 (after controlling for PSS). Yet the causal mediation path via coping flexibility to satisfaction with life was not significant.

Conclusion

This preliminary study emphasizes the important role of both PSS and coping flexibility for the well-being of parents whose children are affected by POMS, a subject that merits heightened consideration among healthcare professionals dealing with long-term chronic diseases.

The importance of parenting self-efficacy and social support for family quality of life in children newly diagnosed with autism spectrum disorder: A one-year follow-up study

Improving the quality of family life (FQoL) is one of the ultimate goals for autism spectrum disorder (ASD) intervention, and parenting self-efficacy and social support are critical for the well-being of families. However, longitudinal studies focusing on FQoL and its predictors for families of children with ASD are scarce. This study aims to describe the characteristics of FQoL among parents of children newly diagnosed with ASD at two waves (newly diagnosed and diagnosed after one year) and to explore the predictors of FQoL at two waves. It was conducted at a tertiary hospital in Guangzhou, China. A total of 156 parents and their children were included in Wave 1, followed up with 110 in Wave 2 after 1 year. The overall satisfaction of FQoL improved (t = -2.128, p < 0.05), while satisfaction with physical/material well-being decreased (t = 5.972, p < 0.01). Additionally, the overall importance rating of FQoL improved but did not have statistical significance (p > 0.05). Parents with higher parenting self-efficacy (β = 0.716, P < 0.01), and more subjective social support (β = 1.127, p < 0.001) reported higher satisfaction with FQoL, and those with better social support utilization (β = 1.066, p < 0.05) reported higher importance for FQoL. FQoL needs to be improved in the early stage of ASD diagnosis, and parental self-efficacy and social support can serve as the intervention targets.