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Chung ST, Lok EYC, Chan QKN, Cheng KM, Lam SM, Lui SSY. Psychometric Properties of the Caregiver Strain Questionnaire in a Chinese Sample of Caregivers of Children with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:3059-3068. [PMID: 37344730 DOI: 10.1007/s10803-023-06028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2023] [Indexed: 06/23/2023]
Abstract
The Caregiver Strain Questionnaire assesses the three dimensions of caregiver strain, namely the objective, subjective externalized and subjective internalized strain. It was validated among caregivers of children with Autism Spectrum Disorder (ASD) in the United States and Mainland China with promising psychometric properties.This study aimed to develop and validate the Chinese (traditional script) version of the Caregiver Strain Questionnaire (C-CGSQ) among 198 caregivers of children with ASD in Hong Kong. The C-CGSQ showed excellent internal consistency (α = 0.958) and test-retest reliability (Spearman's r = 0.966). Concurrent, convergent, divergent validity and a three-factor structure (consistent with previous studies) were established. The C-CGSQ demonstrated promising psychometric properties in measuring caregiver strain among caregivers of Chinese ASD children in Hong Kong.
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Affiliation(s)
| | - Eugenia Y C Lok
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Quinney K N Chan
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Koi-Man Cheng
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Siu-Man Lam
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Udhnani MD, Miller JS, Lecavalier L. Development and Preliminary Validation of the Accommodations & Impact Scale for Developmental Disabilities. J Autism Dev Disord 2024; 54:1870-1881. [PMID: 36871269 DOI: 10.1007/s10803-023-05929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 03/06/2023]
Abstract
The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha = .93) and test-retest (ICC = .95) reliability. Scores were normally distributed and sensitive to age (r = - .19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = - .35), and challenging behaviors (r = .57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children.
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Affiliation(s)
| | - Judith S Miller
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Luc Lecavalier
- Nisonger Center, The Ohio State University, Columbus, OH, USA
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3
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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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Ljungberg M, Schön UK. Who cares? A scoping review about the experiences of parental caregivers of autistic adults. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:929-939. [PMID: 37264729 DOI: 10.1111/jar.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND The autistic population is growing and ageing and this also applies to the parents. Despite this, research about parental experiences is still relatively scarce. Even though studies show, compared with adults with other disabilities, parents of autistic adolescents and adults report a decrease in well-being and that caregiving is often a lifelong commitment. METHOD This scoping review maps, synthesises and identifies gaps in previous research as regards the experiences of parental caregivers of adult autistic children. The review was based on Arksey and Malley's framework and six databases were searched. RESULTS The results show how the research has focused on the well-being and consequences of daily caregiving for an American middle-class mother who co-resides with an adult son. CONCLUSION To enhance knowledge about formal services and service needs, more research is necessary on different welfare regimes and social contexts.
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Affiliation(s)
- Malin Ljungberg
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Ulla-Karin Schön
- Department of Social Work, Stockholm University, Stockholm, Sweden
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Tromans S, Stewart Z, Brugha T. Autism: social care, reasonable adjustments and the personal passport. BJPSYCH ADVANCES 2023. [DOI: 10.1192/bja.2023.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
SUMMARY
Autism is a neurodevelopmental condition associated with differences in social communication and interaction, as well as a restricted, repetitive repertoire of behaviours and interests. Autistic people will have areas of interest and can possess abilities that are of potential benefit to both themselves and wider society. However, many find that their opportunities are limited. Here, we will discuss how a social model of care can help meet the needs of autistic people.
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“The stress can be unbearable, but the good times are like finding gold”: A phase one modelling survey to inform the development of a self-help positive reappraisal coping intervention for caregivers of those with autism spectrum disorder. PLoS One 2022; 17:e0264837. [PMID: 35239745 PMCID: PMC8893638 DOI: 10.1371/journal.pone.0264837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/17/2022] [Indexed: 11/19/2022] Open
Abstract
Caregivers of individuals with ASD can experience various practical, psychological, and social demands and need effective ways of coping to ameliorate the negative effects of caregiving. Numerous coping strategies are available, but the literature shows that caregivers can still struggle to cope, suggesting that interventions to support coping efforts could be beneficial. The MRC framework advocates the systematic development and evaluation of interventions, and this study was conducted to inform the future development of a self-help Positive Reappraisal Coping Intervention (PRCI) for these caregivers. The aim was to establish whether positive reappraisal coping strategies were used and associated with greater psychological wellbeing, prior to developing such an intervention. Method. Caregivers of individuals with ASD (N = 112) responded to items from an existing PRCI (Lancastle, 2006; Lancastle & Boivin, 2008), by writing about aspects of caregiving that reflected the meaning of each item. They also completed questionnaires assessing resilience, caregiving burden, and positive and negative emotions. Results. Participants provided significantly more positive responses than negative responses to PRCI items, demonstrating their use of positive reappraisal coping. Thematic analyses showed that positive responses focused on factors such as their loved one’s personality and achievements, the contributions caregivers had made to this person’s progress, the support received, and their own personal development. Positive reappraisal coping was associated with greater resilience, more positive and less negative emotions, and a lesser sense of caregiver burden. Conclusion. This modelling study suggests that positive reappraisal strategies were used by caregivers and associated with greater psychological wellbeing. The findings will inform the development of a self-help PRCI for the caregivers of those with ASD. Future studies will systematically evaluate that PRCI to determine the nature of intervention effects and mediators and moderators of effects.
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Nighat A, Ahmer Z, Ovais M, Athar FB, Baig LA. Caregiver strain and its predictors among parents of autistic children: a cross-sectional study. J Child Adolesc Ment Health 2022; 34:70-82. [PMID: 38504648 DOI: 10.2989/17280583.2023.2279637] [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: 03/21/2024]
Abstract
Objective: This study estimates the frequency and predictors of caregiver strain (CGS) among parents of autistic children.Methods: Demographic details and CGS were collected through a validated tool from 403 parents of autistic children in Karachi, Pakistan. Regression modelling was performed to report associations between social, behavioural, and communication problems and socioeconomic predictors of CGS. Results were reported using adjusted beta-coefficients with 95% confidence intervals.Results: In total, 88.3% of the parents reported moderate to severe CGS. A high family income (β = -4.31, 95% CI -7.55, -0.11), and caregiver's higher level of education (β = -4.73, 95% CI -8.84, -0.61), along with care-recipient age group (β = -9.35, 95% CI -15.17, -3.52) significantly predicted lower CGS. Diagnosis of more than 5 years (β = 7.57, 95% CI 2.36, 12.79), tendency to self-harm (β = 10.75, 95% CI 6.62, 14.88), and social withdrawal in the care-recipient (β = 4.56, 95% CI 1.68, 7.44) were significantly associated with higher CGS.Conclusion: Parents of children on the autistic spectrum suffer from high CGS. There is a need to introduce tailored parenting interventions at the individual and community levels to help parents reduce the CGS, ultimately benefiting their child.
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Affiliation(s)
- Aroosa Nighat
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mohammad Ovais
- Sindh Government Hospital, Liaquatabad, Karachi, Pakistan
| | | | - Lubna Ansari Baig
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
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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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Abstract
Using Walker and Avant's approach, a concept analysis was performed to develop a working definition of caregiver fatigue. Defining attributes of caregiver fatigue identified were "fell into role" by default, outside the norm of role expectations, excess caregiving demand, and exposure to prolonged period of caregiving. Model, related, and contrary cases were developed. Antecedent, consequences, and empirical referent of caregiver fatigue were also identified. Lastly, a working definition of caregiver fatigue was developed.
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Lee GK, Krizova K, Shivers CM. Needs, strain, coping, and mental health among caregivers of individuals with autism spectrum disorder: A moderated mediation analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1936-1947. [PMID: 30892929 DOI: 10.1177/1362361319833678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study investigated the relationships among caregiving strain, coping, and mental health among caregivers of individuals with autism spectrum disorder (ASD) and the mediational moderation of caregiver needs. One hundred and ninety-three caregivers of individuals with ASD completed an online survey. Results showed that maladaptive coping behaviors were significant in mediating the relationship between strain and mental health. Professional service and emotional caregiving needs moderated the relationship between maladaptive coping and mental health at times of high caregiving strain, but not involvement, health information, and instrumental support needs. Results highlighted the negative effect of maladaptive coping, as well as professional service and emotional support needs were salient in moderating coping and mental health in times of high caregiving strain.
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