Social support and family quality of life in Chinese families of children with autism spectrum disorder: the mediating role of family cohesion and adaptability

Enhancing the quality of life of mothers of children with intellectual disabilities or Autism: The role of disability-specific support

BACKGROUND

A holistic approach considering the physical, emotional, and social dimensions of living with a disability is essential for developing effective support systems, policies, and interventions. The quality of life of individuals with disabilities is interrelated with the well-being of their families making family quality of life (FQOL) a crucial aspect of study.

AIMS

This study explores the effects of support on FQOL among Saudi Arabian families with children diagnosed with intellectual disabilities or autism, from the perspectives of 269 mothers.

METHODS AND PROCEDURES

Through a survey, we examined how disability-related support correlates with FQOL, emphasizing the need for personalized support systems. We employed multiple regression analysis to assess the impact of various factors on FQOL, including the type and severity of disability, family income, and marital status.

OUTCOMES AND RESULTS

The findings revealed that disability-related support is a significant predictor of FQOL, highlighting its critical role in enhancing the well-being of families.

CONCLUSIONS AND IMPLICATIONS

This study contributes to the scarce regional literature, and underscores the importance of inclusive social policies tailored to the diverse needs of families with disabilities.

"Capable of much more": The effects of vocational training on caregiver expectations for neurodivergent dependents in Thailand

Neurodivergence encompasses a spectrum of natural variations in neurological development, including autism, ADHD, and other expressions of cognitive diversity. Caregiver experiences while supporting their neurodivergent dependents critically influence the quality of life outcomes for neurodivergent dependents across life stages, including during the search for work. However, research on caregiver experiences during this stage remains scarce, especially within lesser studied developing contexts like Thailand. This study explored perspectives of Thai caregivers preparing neurodivergent dependents for employment through a focus group (n = 10) of pre-vocational training caregivers and interviews (n = 13) with post-training caregivers. Analysis revealed significant sociocultural factors introducing stigma that affected acceptance, diagnosis, interventions, and policy support. Both groups reported systemic barriers, doubts about future independence, and hopes to increase advocacy and inclusive attitudes. However, caregivers whose dependents had received the training showed marked shifts in their expectations for their dependents' success. Tailored vocational preparation helping dependents exhibit strengths may transform societal views on neurodiversity from deficiency to natural diversity and enable more meaningful, sustainable futures. These insights elucidate caregiver challenges and aspirations, which can better inform supportive research and interventions in Thailand and other non-Western locales.

Neurodevelopmental disorders and family quality of life: emerging trends and future research directions

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we conducted a scientometric analysis to describe this literature, detect certain variables that could be related to FQoL, and identify tendencies and open questions for future research. A literature search in the Web of Science, PubMed, and Scopus was run and identified 3281 publications published between 1975 and 2022. The results suggest an increase in the quantity of publications on FQoL in ASD and ADHD over the last few years (14% and 12%, respectively). For both research fields, the USA published the highest number of documents, showing that the production related to ADHD and FQoL is concentrated in just a few countries. Thematic analysis revealed several clusters, considering quality of life and children as core themes that are still setting trend lines. Moreover, it would be worthwhile to describe and analyze FQoL not only during the childhood of children with ASD and ADHD but also during their adolescence. IMPACT: Although the relationship between family quality of life and neurodevelopmental disorders could be considered novel, there is a growing interest from an interdisciplinary perspective. Family quality of life should be monitored not only during the childhood of children with ASD and ADHD, but also during their adolescence and adulthood. The analysis of the family quality of life in first-degree relatives and its relationship with protective factors (e.g., resilience and social support) should be explored in future studies.

Leisure, community, workforce participation and quality of life in primary and secondary caregivers of autistic children

Parents of Autistic children often modify their participation in leisure, social, and employment activities to meet the caregiving needs of their child. However, few studies have examined the impact this has on caregiver quality of life (QoL). The aim in the current study was to examine the role of participation in a range of activities on QoL amongst primary and secondary caregivers of school-aged Autistic children. Eighty-eight primary (93% mothers) and 63 secondary (91% fathers) caregivers of Autistic children (aged 7- to 12-years) participated in this cross-sectional study, with time pressure, participation, social support, parenting stress, and QoL measured via an online questionnaire. Compared to secondary caregivers, primary caregivers reported fewer employment hours, increased time pressure, less participation in desired activities, and higher perceived responsibility of domestic and child-rearing tasks. Similar levels of leisure frequency, parenting stress, and QoL were identified by both caregivers. Hierarchical regression revealed caregiver participation as important for QoL in both primary and secondary caregivers. However, when measures of caregiver well-being were added to the model, the unique contribution of participation to QoL was reduced, particularly for secondary caregivers. Overall, the findings demonstrate that despite differences in caregiver roles and responsibilities, participation in meaningful activities was important for QoL in all caregivers.

Relationship between affiliate stigma and family quality of life among parents of children with autism spectrum disorders: The mediating role of parenting self-efficacy

BACKGROUND

The parents of children with autism spectrum disorder (ASD) are under great pressure and experience discrimination in their daily lives, which affects their family quality of life (FQOL).

OBJECTIVE

METHODS: A total of 237 parents of children with ASD were recruited in a university-affiliated hospital in Guangzhou, China, from October 2020 to April 2021 by convenience sampling. The Affiliate Stigma Scale, Parenting Sense of Competence Scale and Beach Center Family Quality of Life Scale were employed for data collection.

RESULTS

The results showed that affiliate stigma negatively predicts total FQOL and the dimensions of FQOL through both a direct effect and an indirect effect through parenting self-efficacy.

CONCLUSIONS

The findings suggest that affiliate stigma is an important predictor of FQOL, and interventions to reduce affiliate stigma and strengthen parenting self-efficacy might be effective in improving FQOL in the parents of children with ASD.

The association between family adaptability and adolescent depression: the chain mediating role of social support and self-efficacy

Objective

Previous research has shown a correlation between family adaptability and adolescent depression. However, there is a lack of studies that have investigated the underlying mechanism between family adaptability and adolescent depression. Based on the Ecological Systems Theory, this study aims to investigate the link between family adaptability and depression in adolescents, mediated by the sequential roles of social support and self-efficacy.

Methods

The sample consisted of 1086 students randomly selected from seven public middle schools in Shandong Province, Eastern China. All the participants filled in the structured self-report questionnaires on family adaptability, social support, self-efficacy, and depression. The data were analyzed using SPSS 25.0 and Structural Equation Modeling (SEM) in AMOS 24.0.

Results

The findings of this study are as follows: (1) Family adaptability is negatively associated with adolescent depression; (2) Social support plays a mediating role between family adaptability and adolescent depression; (3) Self-efficacy plays a mediating role between family adaptability and adolescent depression; (4) Social support and self-efficacy play a chain mediation role between family adaptability and adolescent depression.

Conclusion

It is suggested that early interventions and support should be provided to facilitate adolescents' family adaptability, social support, and self-efficacy, thus reducing their depression and improving mental health of adolescents.

A Systematic Review of Family Functioning in Families of Children on the Autism Spectrum

This article aims to review the literature on family functioning in the field of autism. The search was conducted in August 2021 in PubMed, PsycINFO, and PubPsy and sixty-two articles were included. Studies were published in English between 1980 and 2021 and provided quantitative data from validated measures of family functioning in families with an official diagnosis of autism. Results showed that family functioning appeared more problematic for families of autistic children than non-autistic ones. Difficulties were correlated with more caregiver demand and less resources. Interventional results varied. The findings highlight the importance of considering family functioning when providing care for autistic children and their families. Limitations and implications for future research are discussed.Prospero registration number: CRD42022297696.

Family functioning in students of health sciences in four Latin American countries: a study of the structure and factorial invariance of the FACES III scale. A cross-sectional study

BACKGROUND

Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure.

OBJECTIVE

The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico.

METHODS

A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305).

RESULTS

The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries.

CONCLUSION

It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.

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.

Spring is not yet here: raising a child with ASD in rural southwest China

PURPOSE

This study aims to reveal the parenting experiences of parents of children with autism spectrum disorder (ASD) in rural southwest China under the framework of ecological systems theory.

MATERIALS AND METHODS

Semi-structured interviews were conducted with 21 parents of children with ASD from rural southwest China and the interview data were analyzed using the three coding steps of the grounded theory method, namely open, axial, and selective coding.

RESULTS

The results showed four themes: challenges from within the family; relationships between parents, the school, and the community; scarcity and low accessibility of available resources and services; the culture of discriminating against people with disabilities and the loss of eligibility for welfare. The mismatch between the needs of families of children with ASD and the resources available in social-environmental systems is the major issue faced by parents.

CONCLUSIONS

Raising a child with ASD in rural southwest China is affected by the interactions between the families and the internal structures in different environmental systems. The culture of discriminating against people with disabilities formed in the macrosystem could be the essential factor that affects the smoothness of the parenting process of children with ASD.

Time Balance and Family Functioning: The Role of Time Perspective in the Cohesion and Adaptability of Families with Adolescents

Family functioning, understood as cohesion and adaptability, is critical in families with adolescent children, given the changes that this stage implies at the family level. Time perspective is one variable that can facilitate better family functioning through the way people give meaning to the process they live. In this study, we examined the relationship between family functioning and the time perspective of adolescent children's parents. The FACES IV and ZTPI were administered to 276 parents of adolescents. Regression analyses indicated that the past positive, past negative, and future scores predicted family cohesion and adaptability, explaining at least 20% of the variance. Balanced families, with greater cohesion and adaptability, presented a higher level of past positive and future-oriented temporal perspectives, compared to unbalanced families, which presented a greater orientation to the past negative and deviated from the balanced temporal profile. The importance of considering the inter-relationship between family functioning and time perspective was discussed, considering its impact on the health and well-being of families with adolescents.

Participants' Bias in Disability Research on Family Quality of Life during the 0-6 Years Stage

BACKGROUND

Over the past two decades, various research teams have designed and applied instruments to measure the quality of life of families with a member who has a disability. A recent systematic review on the state of the Family Quality of Life in early care identified that many of these studies collected data only from the mothers. The present study aimed to investigate whether there is a bias in participant selection in these types of studies.

METHOD

A systematic review of the scientific literature was conducted in three databases-Scopus, Web of Science, Eric-from 2000 to 2022. A total of 72 empirical studies were identified.

RESULTS

The findings indicate that most studies examining the Family Quality of Life were based on the information of a single informant per family unit. The profiles of participants according to the research objective are quite similar. In one-third of studies, the authors reported that family members who participate cannot be represented by only mothers or one participant per household.

CONCLUSIONS

Given the dynamic and collective nature of the construct, the application of a systemic approach is necessary.

Parental stress and support perception in southern Italy's households with intellectual disabilities and/or autistic spectrum disorder before and during the COVID-19 pandemic

The stress experienced by parents of persons with Intellectual Disability (ID) and Autism Spectrum Disorder (ASD) is higher than that of parents of neurotypical children (TD). An important protective factor is the perception of the support received within the family and the social network. The emergency of the COVID-19 pandemic had a negative impact on the health of people with ASD/ID and their families. The aim of the study was to describe the levels of parental stress and anxiety before and during the lockdown in southern Italy's families with ASD/ID persons and analyze how the levels of support perceived by these families. 106 parents, the ages of 23 and 74 years (M = 45; SD = 9), from southern Italy responded to an online battery of questionnaires measuring parental stress, anxiety, perception of support and attendance at school activities and rehabilitation centers, before and during lockdown. In addition, descriptive, Chi-Square, MANOVA, ANOVAs, and correlational analyses were conducted. The results showed that during the lockdown, attendance at therapies and extra-moenia activities and participation in school activities drastically dropped. During lockdown, parents felt inadequate. The parental stress and anxiety were moderate, but the perception of support dropped significantly.

Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective

Based on the network theory of mental disorders, this study used network analysis to examine the network of ODD symptoms and multilevel family factors and identify the most crucial family factors influencing ODD symptoms in children. A total of 718 Chinese migrant children aged 7-14 years participated in this study. This study measured ODD symptoms, family system-level variables (3 factors), family dyadic-level variables (6 factors), and family individual-level variables (6 factors) with factors selected based on the multilevel family factors theory of ODD symptoms. The results indicated that (1) "annoy" was the center symptom of ODD, (2) "annoy" and "vindictive" was the main bridge connecting the multilevel family factors, and (3) family cohesion at the family system level, parent-child conflict at the family dyadic level, and parental depression at the family individual level were critical central and bridging influencing factors. The findings of this study highlight the critical role of "annoy" and "vindictive" symptoms in the activation of ODD symptom networks in children and provide a basis for future improvements in diagnostic criteria. These potential core and bridge factors might become key intervention targets for childhood ODD.

Vulnerability to loneliness among fathers of children with autism spectrum disorder: The role of interpersonal and familial resources

Fathers of children with autism spectrum disorder (ASD) might be at increased risk of becoming lonely. In the current study, we explored the differences in loneliness between fathers of children with and without ASD and identified interpersonal and familial resources (social support, family cohesion, and family adaptability) that might be related to levels of loneliness. Using a cross-sectional design, 348 fathers (of 114 children with ASD and 234 without) completed a series of questionnaires. Fathers of children with ASD reported higher levels of loneliness and lower levels of social support and family cohesion. A moderated mediation model indicated that the interaction between social support and family cohesion mediated the association between ASD group (i.e., ASD vs. non-ASD) and fathers' loneliness. Findings suggest the importance of interpersonal and familial resources (e.g., perceived social support and family cohesion) for family members at risk of loneliness.

Leisure, employment, community participation and quality of life in caregivers of autistic children: A scoping review

LAY ABSTRACT

We searched a wide range of academic journals for published information on the participation levels of caregivers of autistic children in activities relating to leisure, social, community and employment contexts, and the impact that participation may have on caregiver quality of life. Overall, we found that the impact of parenting an autistic child is broad with caregivers often prioritising their child's needs over their own, particularly in occupational participation, which impacts their quality of life. Findings also highlighted a need for further research to investigate the experience of caregivers, and the relationship between participation and quality of life in caregivers of autistic children, as the results can inform the development of better supports for them.

Social Support and Family Functioning during Adolescence: A Two-Wave Cross-Lagged Study

The influence of social and family factors on adolescent mental health has been widely valued. Considering adolescents' family systems in a broader social context facilitates a better understanding of their mental health, which also has special significance in the post-epidemic era. The purpose of the present study was to explore the relationship between social support and family functioning during adolescence. Students from two middle schools in Fujian province, China, were recruited as participants. Seven hundred and fifty-four participants completed the questionnaire twice in six-month intervals. We constructed a cross-lagged model by using IBM SPSS AMOS 26.0 to test the relationship between these two variables. Social support and family functioning predicted each other in the girls, but not for the boys' sample. The results of this study suggested that the interaction between family and social factors and the possible gender differences should be considered when dealing with adolescents' mental health problems.

The Mediating Effect of Parenting Stress on the Relationship Between Social Support and Quality of Life in Parents of Children With Autistic Spectrum Disorder: A Meta-Analytic Structural Equation Modeling

OBJECTIVE

The aim of the present study is to investigate whether parenting stress mediate the relationship between social support and quality of life in parents of children with Autistic Spectrum Disorder. In addition, we examined what other variables moderate the relationships in this mediation model.

METHODS

Using the two-stage meta-analytic structural equation modeling approach (MASEM), 44 correlation matrices were synthesized from 28 empirical studies (N = 13,270) and fitted to the hypothesized mediation model.

RESULTS

There is a significant partial mediation effect of parenting stress on the relationship between social support and quality of life. Subgroup analysis through the first stage analysis suggested that social support measurements, parental role, and child's age moderated the relationship between social support and parenting stress, and that the focus of quality of life moderated the relationship between social support and quality of life. Subgroup analysis through the second stage analysis indicated that parenting stress had a significantly stronger predictive effect on quality of life in Western culture, while the predictive effect of social support on quality of life was significantly stronger in Eastern culture.

CONCLUSION

Having more social support can reduce parents' stress and then improving their quality of life, which can help them cope more positively and effectively with their autistic children.

Social Support and Family Functioning in Chinese Families of Children with Autism Spectrum Disorder

Families caring for children with autism spectrum disorder (ASD) have reported poorer family functioning. Social support might strengthen family functioning, but limited research to date has focused on this association in China. This study conducted a cross-sectional survey of Chinese families that have children with ASD to examine the relationship between social support and family functioning. Caregivers of children with ASD from Sichuan province in China (N = 167) were surveyed concerning their perceived social support and family functioning. The Social Support Rating Scale was used to investigate caregivers' perceived social support from three dimensions: subjective support, objective support, and the utilization of support. A Chinese version of the Family Adaptability and Cohesion Scale was used to investigate their perceptions of family cohesion and adaptability. The Pearson correlation coefficient and stepwise multiple regression were used for analyses. The results suggested that social support was positively related to family cohesion and adaptability. Of the three sub-domains of social support, both subjective support and the utilization of support were positively associated with family cohesion and adaptability. The study's findings evidenced the importance of different types of social support and could be used to develop a targeted support service for families that have children with ASD to improve their family functioning and sustain the family unit.

Evolution of the Autism Literature and the Influence of Parents: A Scientific Mapping in Web of Science

Parents interventions are relevant to address autism spectrum disorder (ASD). The objective of this study is to analyze the importance and evolution of ASD and its relationship with the parents (ASD-PAR) in the publications indexed in Web of Science. For this, a bibliometric methodology has been used, based on a scientific mapping of the reported documents. We have worked with an analysis unit of 1381 documents. The results show that the beginnings of scientific production date back to 1971. There are two clearly differentiated moments in scientific production. A first moment (1971-2004), where the production volume is low. A second moment (2005-2019), where the volume of production increases considerably. Therefore, it can be said that the subject began to be relevant for the scientific community from 2005 to the present. The keyword match rate between set periods marks a high level of match between periods. It is concluded that the main focus of the research on ASD-PAR is on the stress that is generated in families with children with ASD, in addition to the family problems that the fact that these children also have behavior problems can cause.