Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome

Made to feel different: Families perspectives on external responses to autism and the impacts on family well-being and relationships

LAY ABSTRACT

The influence of the environment on different groups of people with disabilities has rarely been studied in the context of neurodevelopmental disabilities, such as autism, in adolescence. This study explored how external responses to autism affect the experiences, outcomes and family relationships of autistic adolescents and their family members, including siblings and parents. This study adds to the knowledge of factors that contribute to the social disadvantage and exclusion autistic adolescents and their families face in their communities. Interviews with 30 participants from families with an autistic adolescent show that external factors greatly impact the well-being of autistic adolescents and their families. The school environment, including sensory overload, bullying and negative interactions with teachers, was found to be a key factor that negatively influenced mental health and family relationships. The study also revealed that isolation and stigma are major concerns for families, indicating the importance of public awareness campaigns to increase understanding of autism. In addition, the lack of adequate support and services presented significant challenges for families. The study emphasises the importance of person-centred approaches to providing services, which involve including autistic individuals and their families in designing and delivering support.

Predictors of Change in Wellbeing and Mental Health of Parents of Autistic Pre-Schoolers

Parenting is a rewarding experience but is not without its challenges. Parents of Autistic children face additional challenges, and as a result can experience lower levels of wellbeing and more mental health problems (i.e., depression, anxiety, stress). Previous studies have identified concurrent correlates of wellbeing and mental health. However, few have investigated predictors of subsequent wellbeing and mental health, or of change over time, among parents of pre-school aged autistic children. We examined child-, parent-, and family/sociodemographic factors associated with change in parents' mental health and wellbeing across three timepoints (spanning approximately one year) among 53 parents of Autistic pre-schoolers (M = 35.48, SD = 6.36 months. At each timepoint, parents reported lower wellbeing and greater mental health difficulties compared to normative data. There was no significant group-level change over time in parent outcomes. However, individual variability in short-term (~ 5 months) wellbeing and mental health change was predicted by a combination of child- and parent-related factors, while variability in medium-term (~ 10 months) change was predicted by parent factors alone. Parents' description of their child and their relationship predicted change in both wellbeing and mental health. Furthermore, participating in a parent-mediated intervention (available to a subgroup) was a significant predictor of change in wellbeing. Our findings highlight potentially modifiable factors (e.g., learning healthier coping strategies) that may positively impact both short- and medium-term change in parental outcomes.

Autism spectrum: parents' perspectives reflecting the different needs of different families

BACKGROUND

Parents of children on the autism spectrum often face great challenges in the care of their child. Early support tailored to families' individual needs is therefore crucial for the development and quality of life of both children on the autism spectrum and their families. However, to date it is unclear whether the support available meets the parents' needs.

STUDY AIM

To investigate how the system of care, support, and therapies for children on the autism spectrum is perceived by their parents.

METHOD

A total of 57 parents of Swiss children on the autism spectrum participated in an online survey, and 20 of them participated in additional semi-structured interviews.

RESULTS

We found that parents of children on the autism spectrum may face substantial challenges and that social support is essential. Two thirds of the participating parents reported a long and difficult diagnostic process as challenging, and 60% expressed their need for closer follow-up after diagnosis and more support. Only one third of the parents stated that they manage their everyday lives well, whereas 17.5% felt exhausted, and more than half of the parents responded that they felt challenged. One fifth indicated that they had poor family support, and half reported substantial financial challenges. At the same time, most families also emphasize how important their neurodivergent children are to the family`s life together.

CONCLUSION

It is important that primary pediatricians not only initiate the diagnostic process, but also assess the different needs of the different family independent of the diagnosis and, if necessary, initiate adequate measures or guide parents to institutions in charge. Parents who do not actively express their individual needs should nevertheless be advised about support services, including financial counseling. The positive aspects mentioned by families can be emphasized and used as resources to improve their quality of life.

Leisure, Employment, Community Participation, and Quality of Life in Primary Caregivers of Autistic Children: A Qualitative Study

PURPOSE

In prioritising the needs of their autistic children, parents often modify their own participation across leisure, social, and workforce activities. Few studies have examined the impact these modifications have on caregiver quality of life (QoL). The aim in the current study was to examine how parenting their autistic child/ren impacts parent's participation and QoL.

METHODS

Twenty primary caregivers (29-48 years, all female) of autistic children (7-11 years) were interviewed online about their participation in leisure, community, and employment activities including the impact of COVID-19.

RESULTS

Five themes with underlying subthemes were identified using reflexive thematic analysis. The themes were: (1) Reflecting on the important things in life, (2) Getting access to everything needed, (3) Barriers to participation in meaningful activities, (4) Facilitators of participation in meaningful activities, and (5) Participation through the COVID-19 pandemic.

CONCLUSION

The findings highlight the importance of regular participation in meaningful activities for parents of autistic children and the support needed by them, particularly single parents, to achieve balance between meeting caring responsibilities and their own participation needs.

Reducing Depressive Symptoms Among Latina Mothers of Autistic Children: A Randomized Controlled Trial

This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children. In this two-site randomized waitlist-control study (n = 109 mother-child dyads), a peer-to-peer mentoring (promotora) model was used to deliver an intervention that was designed to increase mothers' self-efficacy and use of evidence-based strategies. We assessed mothers' depressive symptom (CES-D) scores at three time points and used linear mixed models to determine whether their scores significantly changed from baseline to postintervention (Time 2) and at 4 months postintervention (Time 3). Results show that mothers in the intervention group reported a significant decrease in mean depressive symptom scores at Time 2 and that the effect was maintained at Time 3 with intermediate to medium effect sizes. There were no differences in results across sites. Findings suggest that Parents Taking Action, a culturally tailored intervention led by peer mentors, showed a significant effect both immediately after the intervention and 4 months postintervention in reducing depressive symptoms among Latina mothers of autistic children.

Investigating the caregiving burden and stress of mothers with children with special needs

BACGROUND

This research was conducted to examine the caregiving burden and stress situations of mothers with children with special needs.

METHODS

The research, which is descriptive and correlation-seeking, was conducted between September 2022 and September 2023 in special education and rehabilitation centers in a city in eastern Turkey. The population of the research consists of the mothers of 2072 children who received education in the specified Special Education and Rehabilitation Centers between the specified dates. The sample size was determined to be 324 individuals based on the known sampling method. "The Personal Information Form, the Zarit Caregiving Burden Scale, and the Perceived Stress Scale were used to collect the data for this study. The data was analyzed using the SPSS package software. For the interpretation of the data, percentages, means, standard deviations, one-way variance analysis, independent groups t-test, Pearson correlation, and simple linear regression were used.

FINDINGS

Among the mothers, 44% were aged 30-39, 87.0% had a child with a disability, and 51.9% had a child with an intellectual disability. The mean total scores of the mothers were 26.71 ± 8.80 for the Zarit Caregiving Burden Scale and 27.00 ± 11.35 for the Perceived Stress Scale. There is a difference between the mothers' age, education level, income level and the type of disability of their child and the Zarit Caregiving Burden scale score average; It was determined that there was a significant difference between the place of residence and the number of disabled children they had and the average score of the Perceived Stress Scale. A positive correlation was found between Zarit Caregiving Burden Scale scores and Perceived Stress Scale scores of the mothers (p < 0.05).

APPLICATION TO PRACTICE

The study revealed that mothers with children with special needs experienced higher levels of stress as their care burden increased. Providing economic assistance and informing and training mothers about the care of children with special needs were recommended to reduce the care burden of mothers with children with special needs.

Close Relationships Despite the Challenges: Sibling Relationships and Autism

This study explores the experiences of siblings of autistic adolescents within families. Without the novel insights generated from engaging with siblings of autistic adolescents within a qualitative framework, it can be challenging to develop strategies for practicing effectively with this group or structuring interventions with these families. Using a social constructivist approach and qualitative participatory methodology, the exploratory study was conducted using in-depth interviews with ten non-autistic siblings, analyzed via a thematic analysis method. The results reveal a common feeling of uncertainty and apprehension in the relationships, leading siblings to physical and emotional detachment from their autistic brothers or sisters. The research emphasizes the caregiving roles predominantly taken up by sisters, especially when the autistic sibling is a brother with intellectual disability. These roles exert substantial demands, with unclear boundaries suggesting potential role confusion. The findings have important implications for family practice, necessitating the need to address role conflict and promote role clarity. They also underscore the gendered nature of caregiving, advocating for support to sister-siblings in these roles. This study revealed the complexities of sibling relationships in families with a member who is an autistic adolescent sibling. The study suggests interventions that promote open family dialogues for a balanced approach to family roles, providing valuable guidance to practitioners to enhance siblings and family well-being.

Conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities: a scoping review

Introduction

To examine the scope of existing literature on the conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities.

Methods

A protocol was developed based on the Joanna Briggs Institute (JBI) scoping review method. MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and EBSCOhost CINAHL, were searched.

Results

Eight studies were selected for inclusion; four used quantitative methodology, and four used qualitative methods. Compassion was not defined a priori or a posteriori in any of the included studies. The concept of self-compassion was explicitly defined only for parents of youth with childhood-onset disabilities in three studies a priori. The most reported outcome measure was self-compassion in parents of youth with childhood-onset disabilities. Self-compassion among parents was associated with greater quality of life and resiliency and lower stress, depression, shame and guilt.

Discussion

There is limited evidence on the conceptualization, use, and outcomes associated with compassion among youth with childhood-onset disabilities. Self-compassion may be an effective internal coping process among parents of youth with childhood-onset disabilities. Further research is required to understand the meaning of compassion to youth with childhood-onset disabilities, their parents and caregivers.

Systematic review registration

https://doi.org/10.17605/OSF.IO/2GRB4.

Psychological wellbeing in parents of children with Down syndrome: A systematic review and meta-analysis

We report a review examining the psychological wellbeing of parents of children with Down syndrome (DS) relative to that of parents of typically developing (TD) children. A systematic search identified 57 relevant studies, which were synthesised meta-analytically. Relative to their counterparts with TD children, mothers and fathers of children with DS reported higher levels of parenting stress (mothers: g = 0.57, 95% CI [0.33, 0.81]; fathers: g = 0.40, [0.24, 0.56]), depressive symptoms (mothers: g = 0.42, [0.23, 0.61]; fathers: g = 0.25, [0.02, 0.48]) and psychological distress (mothers: g = 0.45, [0.30, 0.60]; fathers: g = 0.63, [0.26, 0.99]). Small effects were found for anxiety for mothers (g = 0.16, [0.03, 0.29]), with no differences for fathers (g = 0.03, [-0.25, 0.32]). No group differences were found for positive impact of parenting (mothers: g = -0.09, [-0.25, 0.07]; fathers: g = -0.04, [-0.30, 0.22]), while evidence concerning other positive wellbeing outcomes was limited. No significant moderating effects of child age range, country income level, or group differences in parental education level were identified, but limited subgroup analyses were possible. Raising a child with DS may be associated with elevated stress, depressive symptoms, and psychological distress for mothers and fathers. However, levels of parenting reward appear equivalent to those experienced by parents raising TD children.

Quality of Life and Its Associated Correlates of Parents of Children on the Autism Spectrum in Singapore

This cross-sectional study aimed to assess Quality of life (QoL) of parents of children on the autism spectrum in Singapore and identify its associated factors. Parents of children (age ≥ 5 years) completed the Quality of Life in Autism scale which measures parental self-rated QoL (higher scores denote greater QoL), and the perceived impact of the child's autism-related behaviors on parents (higher scores denote lesser impact). Information on the child's degree of autism (measured by the Social Responsiveness Scale, second edition [SRS-2]), community and social participation and cognitive and adaptive functioning were also obtained. Participants were 86 parents with mean child age 6.3 years (SD 1.0). Univariate analysis results revealed greater participation in community and social events to be two modifiable factors associated with higher parental QoL. However, these factors were not found to be significant in the multivariate model. Higher autism features (represented by higher parent-rated SRS scores) was associated with a greater perceived impact of the child's behaviors by parents in both univariate and multivariate analyses. Of note, child's cognitive or adaptive skills were not significantly associated with either QoL measure. Equipping parents to handle autism-related behaviors can be useful to reduce their impact on parental QoL. Facilitating community participation for these children may positively influence caregiver QoL as well.

The relationship between perceived social support and rumination among parents of children with autism: moderating effect of the degree of intervention received by children

Objective

As the number of children diagnosed with autism rises year by year, the issue of nurturing this particular group becomes increasingly salient. Parents of autistic children, as the nearest and most reliable caregivers for their children, shoulder immense psychological strain and accountability. They are compelled to confront an array of daily life challenges presented by their children, as well as endure multiple pressures such as societal scrutiny and financial burdens. Consequently, the mental health status of the parents is of utmost significance.

Methods

In this study, questionnaire survey combined with literature analysis were applied. The rumination thinking scale and the social support scale were used to investigate the relationship between social support perceived by parents of autistic children and rumination. Meanwhile, the moderating effects of intervention on children with autism were also explored. It hopes that our research would provide a basis for alleviating psychological stress and improving the mental health levels of the parents. A total of 303 parents of children with autism were collected (including 160 females and 143 males). Corresponding data analyses were conducted using SPSS 26.0.

Results

Parents of autistic children generally exhibited high levels of rumination, with significant gender differences. At the same time, the perceived social support by the parents significantly influenced their level of rumination. It showed that the higher the social support received by parents, the lower the level of rumination. More importantly, the extent of intervention received by the children had a regulating effect on rumination of their parents.

Conclusion

The personalized psychological support programs should be developed based on the actual situation of parents, to better manage the challenges presented by raising a child with autism. Our findings would provide important theoretical underpinnings and practical guidance for psychological intervention efforts aimed at families of autistic children. Moreover, these findings offer novel insights for future research, with the potential to advance the field of mental health studies concerning parents of children with autism.

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.

Parenting stress, coping strategies and social support for mothers of preschool children with autism spectrum disorder in the Republic of Croatia

Parents of children with autism spectrum disorder (ASD) report experiencing more parenting stress than parents of children with typical development or other developmental disorders. Eighty mothers of preschool children with ASD completed questionnaires with the purpose of exploring the extent and characteristics of parenting stress and the possibility of predicting parenting stress based on the mother's coping strategies, perceived social and professional support, the severity of the child's symptoms, and certain sociodemographic characteristics. The results show that 19% of the mothers had clinically significant parental stress. Most of the mothers experienced increased stress levels related to the following: poor interactions with their children (34%), the child's demandingness (27%), and their personal ability to cope with parental distress (20%). The predictors significantly explained 42.8% of the variance in total parental stress, with support from friends and severity of the child's symptoms being significant unique contributors.

Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers

LAY ABSTRACT

Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.

Parenthood and Glee: An online study to examine differences between viewers and non-viewers of television shows featuring a character with a developmental disability

We present findings from our study, which examined whether ability to identify Down syndrome and autism was linked to participants' willingness to maintain social contact with individuals with the respective conditions. Additionally, we explored whether viewers and non-viewers of Parenthood and Glee, television shows featuring a character with autism and Down syndrome respectively, differed in their awareness, beliefs regarding causes and interventions, and desire to maintain social proximity with individuals with these conditions. Participants completed an online survey, which included vignettes based on Max, the character with autism from Parenthood and Becky, the character with Down syndrome from Glee as well as the adapted Intellectual Disabilities Literacy Scale. Based on 300 responses, key differences were noted in the hypothesized direction on the assessed variables (symptom recognition, causal beliefs, and treatment beliefs) between Parenthood and Glee viewers and non-viewers. Findings are discussed in the context of practical implications and methodological limitations.

Autism Spectrum Disorder in Down Syndrome: Experiences from Caregivers

This study aimed to learn about the experiences of families of individuals with a dual diagnosis of Down syndrome (DS) and autism spectrum disorder (ASD) (DS-ASD), and to document the journey from early concerns to diagnosis and intervention. Caregivers completed an online survey describing their journey raising a child with DS-ASD. Survey responses were analyzed qualitatively and coded into categories to highlight common themes. Stereotypy, severe communication impairments, and behavioral difficulties prompted caregivers to pursue further evaluation. There was a mean 4.65-year gap between first noticing symptoms and receiving an ASD diagnosis. Several therapeutic interventions were identified as beneficial, including behavioral and communication support. Caregivers expressed frustration and described high levels of stress and social isolation. The diagnosis of ASD in children with DS is often delayed, and caregivers' initial concerns are frequently dismissed. Raising a child with DS-ASD can lead to social isolation and elevated caregiver stress. More research is needed to tailor diagnostic algorithms and therapeutic interventions to the unique needs of this patient population. Caregivers yearn for improved understanding of DS-ASD, more targeted therapies and educational programs, and more overall support.

Positive and challenging themes in parents' perceptions of their relationships with their child with autism: Comparison between mothers and fathers

LAY ABSTRACT

Most studies of how parents of children with autism see the parent-child relationship used questionnaires completed by the parents and focused on challenges. This study broadened the lens by interviewing parents using open-ended questions that provide an opportunity to raise challenging but also positive experiences. Seventy-five mother-father dyads were interviewed individually about their own and their spouses' relationships with their preschooler, and we found nine relationship themes. In descending order, the themes mentioned most frequently by mothers were "Security and Closeness," "Love," and "Tenderness and Sensitivity," and by fathers were "Pleasure in Joint Activities," "Security and Closeness," and "Guidance." Positive themes were more common than challenging themes. Finally, more mothers mentioned the themes "Love," "Tenderness and Sensitivity," "High Involvement and Care," and "Difficulties" than did fathers, whereas more fathers mentioned the themes "Guidance" and "Pleasure in Joint Activities" than did mothers. The findings portray a nuanced view of the parenting experience of mothers and fathers of preschoolers with autism.

A secondary analysis examining the influence of emotional support on the mental health of caregivers of children with autism spectrum disorder

PURPOSE

The study purpose was to examine the effect of emotional support on the overall mental health and stress for caregivers of children with autism spectrum disorder (ASD).

METHODS

A cross-sectional retrospective study using secondary data from the 2016-2019 National Survey of Children's Health was conducted using single variable and multivariable linear regression analyses.

RESULTS

More informal emotional support sources were associated with better overall mental health (β = 0.124, SE = 0.015, p < .001) and reduced stress (β = -0.261, SE = 0.039, p < .001) for caregivers of children with ASD, controlling for covariates. The number of formal emotional support sources was not significantly associated with caregiver overall mental health or stress when controlling for covariates. Increased amounts of total emotional support sources were significantly associated with increased overall mental health (β = 0.042, SE = 0.010, p < .001) and reduced stress (β = -0.093, SE = 0.024, p < .001) for caregivers. Other factors significantly associated with caregiver outcomes included caregiver sex, caregiver marital status, caregiver education level, economic hardship, child sex, child race/ethnicity, ASD severity, and child receipt of ASD treatment.

CONCLUSION

More emotional support sources, in particular informal support sources, may be a protective factor for well-being for caregivers of children with ASD.

PRACTICE IMPLICATIONS

Health care providers should evaluate the impact of their formal support services on caregivers of children with ASD and advocate for increased informal and formal support resources for these caregivers.

Fatigue among Greek Parents of Children with Autistic Spectrum Disorder: The Roles of Spirituality and Social Support

The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated "Close/Very close faith toward God". Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = -0.50, p < 0.001 and r = -0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue.

A Double-Blind Randomised Controlled Trial of Prebiotic Supplementation in Children with Autism: Effects on Parental Quality of Life, Child Behaviour, Gastrointestinal Symptoms, and the Microbiome

PURPOSE

Modifying gut bacteria in children with autism may influence behaviour, with potential to improve family functioning. We conducted a randomised controlled trial to assess the effect of prebiotics on behaviour, gastrointestinal symptoms and downstream effects on parental quality of life.

METHOD

Children with autism (4-10yrs) were randomised to 2.4 g/d of prebiotic (GOS) or placebo for six weeks. Pre and post stools samples were collected, and validated questionnaires used to measure change in social and mealtime behaviours, GI symptoms and pQOL. Linear mixed models evaluated group differences for behavioural variables, and Mann Whitney U tests were used to compare change between-groups for GI symptoms, differential abundance of genera and alpha diversity of the microbiome.

RESULTS

Thirty-three parent-child dyads completed the trial. No group difference was seen for behavioural variables but both groups improved significantly from baseline. There was a medium effect size between groups for GI symptoms (d = 0.47) and pQOL (d = 0.44) driven by greater improvements in the prebiotic group. Bifidobacterium increased threefold following prebiotics (1.4-5.9%, p < 0.001) with no change in controls. Supplements were well tolerated, compliance with dose 94%.

CONCLUSION

Prebiotics modify levels of Bifidobacterium and prove well tolerated but in this instance, resulted in only marginal effects on GI symptoms and pQOL. A larger sample of children with more severe symptoms could help to determine the potential of prebiotics in autism.

TRIAL REGISTRATION

https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619000615189 .

Impact of Child and Family Factors on Caregivers' Mental Health and Psychological Distress during the COVID-19 Pandemic in Greece

Although primary caregivers of children with developmental disabilities (DDs) experience higher levels of distress than primary caregivers of typically developing children do, this problem has received limited attention in Greece. Therefore, this study examined mental health and associated factors among primary caregivers of children with and without DDs in Greece during the COVID-19 pandemic. This cross-sectional study included 156 participants. Primary caregivers completed a self-report survey on sociodemographic characteristics, the Depression, Anxiety, and Stress Scale-21 items, and the 12-item General Health Questionnaire. Primary caregivers of children with DDs, particularly mothers, reported more mental health problems and higher levels of psychological distress than the control group. Among families parenting a child with disabilities, caregivers' psychological distress was significantly related to having a child with autism spectrum disorder and the severity of the child's behavioral difficulties. Significant predictors of caregivers' distress were the parent being female, the child being male, a single-parent family, a lower income, and higher depressive symptoms. Caregivers raising children with DDs face unique challenges in terms of care, necessitating the development of family-based interventions to improve the social-emotional well-being and overall quality of life for both parents and children.

Family Communication in Autism Spectrum Disorder: Applying the Family Caregiver Communication Typology to Parent Caregivers

Parents of children with Autism Spectrum Disorder (ASD) experience greater stress and caregiver burden than parents of children with other disabilities. To cope with the stress of long-term caregiving, they rely on professionals for support and guidance. However, parents continue to report unmet communication and support needs. To inform tailored communication for parents of a child with ASD, this study used the existing Family Caregiver Communication Typology framework which identifies four caregiver communication types (manager, carrier, partner, and lone) and their unique communication and support needs. In-depth, structured interviews were conducted with parents (n = 22) and ASD professionals (n = 28) to explore communication characteristics of ASD parent caregivers. A thematic analysis revealed communication behaviors among four ASD parent caregiver types, further validating the typology. Future research is needed to develop targeted interventions for improving family-centered care based on ASD parent caregiver types.

Children's and Parents' Factors That Affect Parenting Stress in Preschool Children With Developmental Disabilities or Typical Development

OBJECTIVE

This study compared parenting stress in preschool children with developmental disabilities (DD) or typical development (TD). We also investigated children's factors that affect parenting stress.

METHODS

A total of 196 preschool children participated in the study (aged 54.8±9.2 months). There were 79 children with DD (59 with autism spectrum disorder, 61 with intellectual disability, 12 with language disorder) and 117 with TD. The high parenting stress and the low parenting stress groups were divided based on the Total Stress of Korean Parenting Stress Index Fourth Edition (K-PSI-4) with an 85-percentile cutoff score. Pearson's correlation analysis was conducted to calculate the correlation between K-PSI-4 and the children's or parents' measures.

RESULTS

The difference in parenting stress between DD and TD was significant in the Total Stress of K-PSI-4 (p<0.001). The Total Stress scale of K-PSI-4 represented a modest to strong correlation with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Our results showed that caregivers of children with DD reported higher parenting stress than those with TD. Parenting stress was strongly associated with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Among the children's factors, especially social communication, attention problems, and aggressive behavior had association with caregivers' higher parenting stress.

CONCLUSION

These findings suggest the need for early intervention for parenting stress in caregivers by assessing child characteristics, including social cognition, awareness, communication, and inattention and hyperactivity, in the evaluation of children with DD.

Parental Distress and Parenting Behavior in Families of Preschool Children with and Without ASD: Spillover and Buffering

Parents of children with autism spectrum disorder (ASD) report increased distress relative to parents of children with neurotypical development. Parent well-being is generally considered a key determinant of parenting behavior, thus increased distress may spill over into less optimal parenting in families of children with ASD. However, evidence is mixed regarding the degree to which parenting is actually compromised in this population, suggesting the possibility of buffering, wherein the parenting of children with ASD may be robust against spillover from increased parental distress. The current study tested competing spillover and buffering models with regard to relations among child ASD status, parental distress, and parenting behavior. Parents of preschoolers with (n = 73) and without (n = 55) ASD completed self-report measures of parenting stress, depressive symptoms, and emotion dysregulation, as well as of positive and negative parenting behaviors. Families of preschoolers with ASD reported higher distress and negative parenting, and lower positive parenting than did their counterparts. Findings supported the spillover model for negative parenting such that increased parental distress accounted for status-group differences in negative parenting. In contrast, potential buffering was observed for positive parenting in that an inverse association between distress and parenting was observed for parents of children with neurotypical development only. Findings highlight the potential benefit of intervention to reduce parental distress in families of children with ASD, but also suggest some existing ability of these families to buffer certain parenting behaviors from deleterious effects of parent distress.

Applying a Parent Training Program in a Naturalistic Behavior Analytic Context to Improve Attachment in Children with ASD

Infants develop attachment to their caregivers very early on. The quality of attachment is considered to be crucial for the emotional development of humans and animals alike. Despite its importance, very little is known about how attachment develops between children with Autism Spectrum Disorder (ASD) and their caregivers. The purpose of the present study was to assess the attachment patterns of two young children with ASD with their parents and to identify the means for promoting parent, child, and parent-child relational characteristics that may contribute to the development of secure attachment. The results replicated prior findings pertaining to attachment quality of children with ASD and demonstrated the effectiveness of a naturalistic, behavior-analytic intervention in improving the quality of their attachment.

Adaptation at the Family Level in Families of Individuals With Down Syndrome: A Scoping Review

Down syndrome (DS) is a chromosomal disorder associated with intellectual and physical disabilities and has historically been viewed by health care providers through a negative lens when considering the effect the condition has on the individual, family, and community. The purpose of this scoping review was to provide an overview of recent research concerning adaptation in families of individuals with DS with a focus on family adaptation rather than individual or dyadic adaptation. Three literature indexes were searched from 2017 to 2022, with 41 articles included. Foci of the studies included strength/resilience, stress/coping, and negative/challenge. Thirteen studies reported using a family framework. Multiple methodological approaches and family measures were used in the studies and are outlined. Findings from this review show there has been a shift in focus when researching families of individuals with DS from a negative and challenging experience to one of strength and resilience.

Marital Experiences and Parental "Highs" and "Lows" When A Child with Autism Starts School

This study describes parents' daily "highs" and "lows" during their child's transition to school for the first time and examines how those experiences relate to turbulence in the parents' relationship. 106 parents (53 couples) rated their relationship qualities at pre-test and post-test and described "high" and "low" points of their day every three days for 42 days. Content analysis revealed experiences contributing to "high" or "low" points that were primarily related to: the child with ASD, the spouse, other children, personal situations, and other. Latent profile analysis identified three profiles that represented the relationship experiences of couples in the study: resilient couples, couples getting by, and asymmetrically engaged couples. Results highlight the variety of daily experiences these parents encounter.

Profiles of the parenting experience in families of autistic children

LAY ABSTRACT

Research shows that parents of autistic children, on average, are stressed; however, there is likely an array of factors that characterize the parenting experience in the context of autism other than stress. Understanding the diversity in the parenting experiences of both mothers and fathers of autistic children is important in the development of family-based intervention. A total of 188 co-habiting couples with an autistic child described their parenting experiences using a series of questionnaires examining their feelings of stress, parenting competence, and parenting attitudes and behaviors. We then sorted responses into profiles-three for mothers and four for fathers. We found that children of parents who reported the least amount of stress, highest feeling of competence, and use of responsive and directive parenting strategies (the Adaptive profile) had children with the least severe behavioral problems and autism symptoms. It was not necessary for both parents to be in the Adaptive category for child emotional and behavioral problems to less severe. We found that children did just as well when one parent was Adaptive compared with when both parents fell into this category.

Child Attachment Representations and Parenting Stress in Mothers and Fathers of School-Age Children with a Diagnosis of Autism Spectrum Disorder: A Pilot Cross-Sectional Study

Mothers and fathers of autistic children (ASD) tend to report elevated levels of parenting stress. Thus, it is critically important to understand which factors contribute to an imbalance between the perceived demands of parenting and the available psychological resources. To date, little is known about the association between child attachment representations and parenting stress. In this study, we first examined group differences in parenting stress levels based on child diagnosis and parents' gender. Second, we explored the predictive role of child diagnosis, autism severity, and child attachment representations on parenting stress. The study involved 23 school-age children with ASD (IQ > 70), 27 without ASD (7-13 years), and their mothers (n = 50) and fathers (n = 50). Data were collected from 2017 to 2020. Parents completed the Social Responsiveness Scale 2 and the Parenting Stress Index-Short Form, while the children's attachment representations were assessed using the School-age Assessment of Attachment. Parents of children with ASD reported higher stress compared with controls. No differences were found between mothers and fathers. Implicit attachment representations have been found to be associated with parenting stress only in mothers, while the severity of social impairment showed a significant effect on parenting stress in both parents. These findings revealed the potential benefit of adaptive attachment representations not only for children themselves but also for mothers and the family system, suggesting the bidirectional nature of parent-child relationships in the context of ASD. The uniqueness of maternal and paternal parenting experiences should be considered when parenting stress is addressed.

A Moderated Mediation Model of Social Support on the Association between Coping Strategies and Psycho-Emotional Distress of Healthcare Professionals Caring for Children with Autism

Healthcare professionals caring for children with autism spectrum disorder are more likely to be emotionally and psychologically distressed because of the children's challenging behaviors. This study aimed to investigate whether social support mediates the association between coping strategies and perceived emotional and psychological distress among professionals working with children with autism spectrum disorder. Additionally, this study explored the moderating effect of autism severity on this mediation. The study's design is cross-sectional, correlational, and predictive. An online, self-administered questionnaire was used to recruit a convenience sample of 180 healthcare professionals working with children with autism spectrum disorder. The results revealed a significant mediation effect of family social support on the relationship between problem-focused coping and psychological distress for those dealing with moderate or severe autism. Likewise, there was also a significant mediation effect of family social support on the relationship between avoidant coping and psychological distress for those dealing with moderate autism. Familial social support can serve as a protective factor for healthcare professionals caring for children with autism against accumulated psychological distress. The direct effect of avoidant coping strategies on emotional distress changes depending on autism severity. The study's findings are informative to mental health nurses to create more effective coping strategies as problem-solving interventions or develop new coping strategies based on familial social support for those working with children with autism.

Stress Levels and Coping Strategies of Families of Adults With Intellectual Disability and Challenging Behaviours During the COVID-19 Pandemic in Qatar

This study investigated the perceived stress levels and coping strategies of caregivers of adults with intellectual disability and challenging behaviours during the COVID-19 pandemic in Qatar. A cross-sectional survey was conducted from June 7 to September 7, 2020 for caregivers of adults diagnosed with intellectual disability and challenging behaviours. Perceived stress levels and coping strategies were assessed using the Perceived Stress Scale and Brief Coping Orientation to Problems Experienced inventory. Results showed moderate to high perceived stress levels in most caregivers (69%). The most frequent coping strategy was religion, followed by acceptance and active coping. Substance use and self-blame were less frequently used. The study revealed that emotional support, informational support and venting coping strategies were significant predictors of perceived stress levels. Restrictions on physical activity and social mobility caused by pandemic-related lockdowns have placed tremendous pressure on caregivers. Appropriate supportive measures should be implemented for the caregivers.

Narrative analysis of parents' experiences with participating in the intervention of children on the autism spectrum in mainland China

PURPOSE

Although the challenges encountered by parents of children on the autism spectrum during the intervention process have garnered scholarly attention, how parents subjectively review those challenges and construct meanings of their experiences remained underexamined. By applying the narrative analysis framework, we investigated the lived experiences of parents of children on the autism spectrum regarding challenges they faced in the intervention process, along with the meanings of those experiences that they constructed in the sociocultural context of mainland China.

METHODS

We purposively sampled 16 parents to narrate their experiences following semistructured interviews. Each participant had one child who had participated in autism intervention for more than two years.

RESULT

The narrative analysis revealed that parents experienced a series of challenges imposed by structural barriers in the intervention process, which resulted in psychological distress and negative perceptions of their parental identities. Albeit susceptible to those adversities, the parents actively constructed new meanings of parenthood and their children's situations through reflexive dialogues.

CONCLUSION

Our results indicate the essential role of meaning-oriented coping in helping parents with children on the autism spectrum to mitigate the negative influence of challenges on their parental identity, strengthen their parent-child relationships, and readjust their priorities for intervention.IMPLICATIONS FOR REHABILITATIONThe role of encouraging new meanings through reflexive dialogues was found to be particularly important among parents with children on the autism spectrum to cope with the challenges they faced in the intervention process.New meanings assigned can mitigate the negative impact of challenges on parents' parental identity, strengthening their parent-child relationships, and readjusting their priorities for intervention within the Chinese socio-cultural context.It is crucial for social workers and other practitioners to support parents in mainland China by facilitating them to assign new meanings to the challenging situations.It is important for social workers and other practitioners to encourage parents to cultivate inner strengths and self-value to support their children on the autism spectrum.

Exploring Bidirectional Relationships: Child Sleep Duration, Child Behavior Problems, and Parenting Stress in Families of Children with Autism Spectrum Disorder

Background

Youth with Autism Spectrum Disorder (ASD) are at-risk for sleep and behavior problems, and their parents are at-risk for high stress. Child sleep duration, behavior problems, and parenting stress are interrelated; however, directionality of these associations is unclear and research including youth with ASD is lacking. Using a day-to-day, within-person design, this study explores the directionality of these relationships in families of children with ASD.

Method

Twenty-six children (ages 3-5, 73.1% male, 65.4% Hispanic/Latino) with ASD and their mothers participated in a 14-day study. Child sleep duration (parent-report and actigraphy), behavior problems, and parenting stress were measured daily. Constructs were decomposed into their within- and between-person components and analyzed with random intercept cross-lagged panel models.

Results

While between-person relationships were directionally expected in that shorter sleep, more behavior problems, and greater parenting stress were associated, within-person relationships were complicated. Better-than-average child behavior was associated with less next-day parenting stress, yet more parenting stress than average was associated with better next-day child behavior. As expected, longer-than-average child sleep was associated with less next-day parenting stress, while greater child behavior problems were associated with less sleep that night.

Conclusions

Understanding the directionality of associations between child and parent factors allows for the optimization of interventions to improve the quality of life for families of children with ASD. Interventions that target child behavior and/or help parents manage stress while maintaining effective parenting strategies for sleep and behavior may be useful.

Social support mediates the relationship between dispositional gratitude and psychological distress in caregivers of autistic children

Grateful caregivers report lower levels of psychological distress. Social support, engendered by gratitude and buffering against stress, might mediate this effect. Here we explored whether the protective psychological effect of dispositional gratitude might be mediated by increased social support. A sample of 126 caregivers of autistic children completed questionnaires assessing dispositional gratitude, social support and psychological distress. Gratitude inversely predicted psychological distress, as did social support after adjusting for gratitude. Gratitude positively predicted social support. Gratitude no longer predicted psychological distress after adjusting for social support. Indirect effects analysis revealed the gratitude-distress relationship occurred indirectly via social support. Grateful caregivers reported higher levels of social support, and this predicted lower psychological distress. Gratitude, relatively stable as a disposition, has a state component that is sensitive to change, and healthcare professionals might do well to recommend gratitude enhancing interventions for caregivers of autistic children.

Changes in mothers' and fathers' stress level, mental health and coping strategies during the 3 years following ASD diagnosis

BACKGROUND

ASD in a child affects parental mental health, with elevated levels of stress, anxiety and depression reported in parents.

METHOD

In this study, we examined mothers' and fathers' stress, anxiety and depression, as well as their coping strategies in a sample of 103 children and adolescents enrolled in the ELENA cohort study in France at diagnosis and three years after diagnosis.

RESULTS

Results showed that mothers had higher levels of stress and anxiety / depression than fathers and used more social support coping strategies at diagnosis, which might be explained by increased levels of parental involvement. Mothers' stress level significantly decreased during the three years following ASD diagnosis but no such decrease was observed in fathers' stress level. A significant decrease in anxiety and depression was observed for both parents, suggesting that parental distress is particularly elevated during the critical diagnosis period. Results finally yielded a significant decrease in emotion-focused coping strategy in mothers over the three-year period, an ineffective strategy that takes places at the time of diagnosis but then decreases during the period following ASD diagnosis, in relation to the acceptance process.

CONCLUSIONS

Implications in terms of addressing the unmet mental health needs of parents and their coping strategies are discussed.

How do autistic severity and family functioning influence parental stress in caregivers of children with autism spectrum disorder in China? The important role of parental self-efficacy

Introduction

Parental stress among primary caregivers of children with autism spectrum disorder (ASD) is a significant concern. While previous research indicates that both family and child factors substantially influence parental stress, a few studies have comprehensively examined these factors from family, parent, and child perspectives. Moreover, the psychological mechanisms underlying parental stress remain underexplored.

Method

This study obtained a valid sample of 478 primary caregivers of children diagnosed with ASD in China and employed mediation and moderated mediation analyses to investigate the relationships between family adaptability and cohesion (FAC), ASD severity, parental self-efficacy, and parental stress.

Result

Results revealed that higher FAC was linked to reduced parental stress through increased parental self-efficacy. The indirect effect of parental self-efficacy was more substantial for caregivers of children with severe symptoms than those with mild symptoms.

Discussion

These findings offer insights into how FAC influences parental stress and underscore the importance of parental self-efficacy as a coping resource for mitigating parental stress. This study provides valuable theoretical and practical implications for understanding and addressing parental stress, particularly in families raising children with ASD.

Examining indicators of psychosocial risk and resilience in parents of autistic children

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.

The impact of autism spectrum disorder on parent employment: Results from the r-Kids study

Parents of children with autism spectrum disorder (ASD) and other chronic health conditions often face exceptional caregiving demands that can lead to challenges related to maintaining and succeeding in employment. Detailed information on the specific ways in which these health conditions impact parent employment could aid in designing equitable, effective policies to support families. The r-Kids study used electronic health records to identify three groups of children: those with ASD, asthma, or neither condition (control), from several health care systems. We oversampled racial and ethnic minorities and matched the asthma and control groups to the age and sex distribution of the ASD group. Parents completed three online surveys over the course of a year to measure annual employment outcomes. Surveys included the Family Economic Impact Inventory (measuring employment impacts) and measures of quality of life and symptom severity. All materials were provided in English and Spanish. The study enrolled 1461 families (564 ASD, 468 asthma, 429 control). Youth were 3-16.5 years old and predominantly male (79%). The sample was diverse (43% non-Hispanic White; 35% non-Hispanic Asian, Black, Native Hawaiian, or Other; and 21% Hispanic ethnicity). Parents of children with ASD were significantly less likely to be employed than parents of youth with asthma and control combined (OR: 14.2, p < 0.001), and were more likely to have other difficulties with employment and productivity while at work. Public and employer policies to help mitigate these impacts could aid families in managing care for youth with ASD.

What factors are associated with posttraumatic growth among mothers of children with developmental disabilities in South Korea?

BACKGROUND

The identification of PTG and its correlates in the aftermath of a traumatic event would assist professionals in recognizing and amplifying individual's potential strengths. However, there are few studies on PTG and its correlates in mothers who have birthed or raised children with developmental disabilities in South Korea.

AIM

This study examined the predictive role of caregiving strain and social support on the subdimensions of PTG among South Korean mothers of children with developmental disabilities.

METHODS AND PROCEDURES

The participants were 344 mothers of children with intellectual disabilities or autism. PTG was divided into four sub-dimensions (change in self-perception, increase in interpersonal depth, finding new possibilities, and increase in spiritual interest), and the predictive roles of caregiving strain and social support on each sub-dimension were identified using hierarchical multiple regression.

OUTCOMES AND RESULTS

Subjective caregiving strain; family support services; and support from family, friends, or significant others were significantly related to the subdimensions of PTG. Interestingly, support from significant others was positively associated with PTG.

CONCLUSIONS AND IMPLICATIONS

Social support was more likely to influence all subdimensions of PTG, except for changes in self-perception while only subject caregiving strain was associated with PTG. Thus, policymakers and practitioners should prioritize expanding family support services and strengthening various informal supportive resources for mothers with higher PTG.

Trends in Autism Spectrum-Related Motherhood Research: A Bibliometric Study

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in socialization. The amount of scientific research results on motherhood related to ASD has grown exponentially; however, there are no bibliometric studies in this field. Objective: This article aimed to analyze scientific research on motherhood related to the autism spectrum published in WoS. Articles on motherhood related to ASD were retrieved from the Web of Science (WoS). The advanced search interface used was "Title of the article, Abstract, Keywords". The analysis and visualization of the selected documents and their data were performed using a wide range of tools and software such as MS Excel (v16.0), VOS viewer (version 1.6.15), and R packages (Biblioshiny, version 2.0). A total of 1660 articles were included in this study. Most of the publications were original articles. The United States published the most significant number of articles among the countries identified. P.R. Hastings, M.M. Seltzer, and J. Van de Water were the main authors. The Journal of Autism and Developmental Disorders was the most productive and impactful journal. The main research topics were related to mental health and social support in the role of motherhood. This desk study provides researchers with a comprehensive understanding of ASD-related maternity research trends by evaluating relevant publications in recent decades. The results of this bibliometric analysis can serve as a basis and orientation for new studies.

Economic burden on caregivers or parents with Down syndrome children-a systematic review protocol

BACKGROUND

Financial burden is a common phenomenon, often noticed in the caregivers of children with Down syndrome. It echoes adverse effects on the caregiver's mental and physical health. The economic burden covers direct healthcare costs, direct non-health-care costs, and indirect costs and is substantial for the family of a person with Down syndrome, as well as for society. Evidence, in this area, is necessary to reduce mental stress and promote financial well-being among caregivers.

METHODS

In this review, quantitative studies that assess the economic burden on caregivers of children with Down syndrome will be considered. We will perform a systematic literature search conducted from the year 2000 to 2022 on electronic databases CINAHL, EBSCO, EMBASE, PubMed, Scopus, Web of Science, and EconLit. An additional gray literature search will be carried out. Two researchers will independently conduct the screening and data extraction and assess the risk of bias.

DISCUSSIONS

The review attempts to methodically analyze the economic burden among caregivers of children with Down syndrome from the societal perspective and individual perspectives. The current study will provide an evidence base to researchers, academicians, and society in identifying need-based learning to caregivers, and the selection of appropriate therapies for children suffering from Down syndrome.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021265312.

Daily experiences and well-being of Chinese parents of children with autism

LAY ABSTRACT

The present study examined the influences of child-related stress, parental coping and social support on parental daily subjective well-being (i.e. positive and negative affect, life satisfactory) in Chinese families of children with autism spectrum disorder. For 14 days, a total of 76 parents (58 mothers) participated in the study and completed daily diaries. For mothers, child-related stress was related to lower life satisfaction; social support was related to higher life satisfaction that day. These daily relations were not found for fathers. Across all parents, avoidant coping was associated with higher negative affect and lower positive affect on the same day. Notably, daily positive coping was related to greater same-day positive affect as well as greater same-day and next-day life satisfaction. Interventions aimed at increasing positive coping and social support, and reducing child-related stress and avoidant coping are important to help parents maintain well-being, particularly for mothers of children with autism.

Dyadic Effect of Coping on the Perceived Impact of ASD of Children on Parental Quality of Life: Report from the ELENA Cohort

Autism spectrum disorder (ASD) has a significant impact on the quality of life (QoL) of families. This study aimed to examine, for parents of children with ASD, the dyadic effect of each parent's coping strategy on the perception of the impact of ASD on their QoL. In total, 164 couples completed self-report questionnaires, including the Par-DD-QoL, to evaluate the parental perception of QoL. Results from the actor-partner interdependence model showed that, in addition to the effect of the mothers' and fathers' emotion-focused coping on their own perception of QoL, the mothers' emotion-focused coping plays a key role in the fathers' perception of QoL. These findings suggest that both parents of children with ASD would benefit from couple-focused interventions.

Parent-mediated intervention training for caregivers of children with developmental differences in Zambia

BACKGROUND

Lower- and middle-income countries (LAMICs) are under-resourced and have limited intervention services for children with developmental differences and their families. A logical method to address service gaps within resource-scarce contexts is to train caregivers as interventionists, specifically using empirically-supported parent-mediated Naturalistic Developmental Behavioral Interventions (P-M NDBIs; Kasari et al., 2010; Ingersoll & Wainer, 2013).

AIMS

The study implemented the first P-M NDBI in Zambia and aimed to train caregivers and improve children's social-communication skills.

METHODS/PROCEDURES

The current study utilized a mixed-methods, pre-post design and implemented Project ImPACT (Ingersoll & Dvortcsak, 2010, 2019). Participants included 19 Zambian caregivers of children (n = 20) with developmental differences including autism spectrum condition, Down syndrome, and cerebral palsy.

OUTCOMES/RESULTS

Findings indicated that children's language skills and pretend play skills significantly improved from pre- to post-assessment, and caregivers most frequently used intervention strategies for modeling communication and prompting communication.

CONCLUSIONS/IMPLICATIONS

The success and feasibility of implementing Project ImPACT in Zambia, and recommendations for culturally adapting and implementing P-M NDBIs in LAMICs, were discussed.

Parents' pandemic stress, parental involvement, and family quality of life for children with autism

Background

Research has shown that parents of children with autism spectrum disorder (ASD) suffered high levels of stress during the COVID-19 pandemic and faced poor family quality of life (FQOL). However, little is known about the inherent dynamic interaction between pandemic stress and FQOL, especially in the Chinese cultural context.

Aims

This study provides preliminary evidence by examining the relationships among pandemic stress, parental involvement, and FQOL for children with autism in mainland China.

Method

A total of 709 parents of children with autism completed measures of FQOL, parental involvement, and pandemic stress. Structural equation modeling was employed to examine the interrelations among these variables.

Results

Pandemic stress has direct effect and indirect effect mediated by parental involvement on FQOL. Two dimensions of pandemic stress had a direct effect on FQOL (β1 = 0.11; β2 = -0.55) and three dimensions had an indirect effect on FQOL through parental involvement (β1 = -0.097; β2 = 0.257; β3 = 0.114).

Conclusion

Stress related to the COVID-19 pandemic affects family quality of life for children with autism in complex ways. Policies may be developed to enhance parental pragmatic hopefulness in the anti-epidemic victory and alleviate negative physical and mental reactions caused by the pandemic.

Neuropsychological features in RASopathies: A pilot study on parent training program involving families of children with Noonan syndrome

Noonan syndrome (NS) is a clinical variable multisystem disorder caused by mutations in genes encoding proteins involved in the RAS/mitogen-activated protein kinase signaling pathway. NS is characterized by a distinctive facies, short stature, and congenital heart defects. Psychomotor delay, learning difficulties, and social deficits are also common. Furthermore, behavioral and attention problems can be reckoned as a key symptom in NS, with functioning resembling the patterns observed in attention deficit hyperactivity disorder (ADHD). The complex behavioral phenotype has great impact on the quality of life and raises demanding management issues also for patients' families. Parent management training (PMT) is recommended as first-line treatment for ADHD; however, no study has been performed to test the efficacy of PMT in NS, thus far. The aim of this pilot study is the implementation and evaluation of a PMT dedicated to NS families. Parents of seven children with NS were recruited and underwent to a 10-session PMT. Three different questionnaires were administered to both parents: Conners Parent Rating Scales, Parenting Stress Index Short Form (PSI-SF), and Alabama Parenting Questionnaire (APQ). Our findings on this first small cohort of families indicate that positive perception and satisfaction about the child and the interaction with him increased in mothers after the intervention, as measured respectively by PSI-SF difficult child (DC) and PSI-SF parent-child dysfunctional interaction (PCDI), while mothers' level of stress decreased after the PMT, as indicated by PSI-SF total scores. Furthermore, APQ positive parenting, which measures behaviors of positive relationship with the child, increased in mothers after the intervention. Statistical analysis on fathers' questionnaires did not show significant differences after the PMT sessions. This pilot study suggests that PMT is a promising intervention for parents of NS children with behavioral and ADHD symptoms. Changes in mothers' attitudes and distress indicate that behaviorally oriented programs may help parents to manage with NS phenotype.

Coping-resilience profiles and experiences of stress in autistic adults

Emerging studies allude to high stress in autistic adults. Considering the detrimental impact of stress on health outcomes, examining individual resources which may influence the extent to which stress is experienced (e.g., coping and resilience) is vital. Using a person-focused approach, this study aimed to identify coping-resilience profiles, and examine their relations to general perceived stress and daily hassles in a sample of autistic adults (N = 86; aged 19-74 years). Cluster analysis identified four coping-resilience profiles (i.e., high cope/ low resilience, low cope/ high resilience, engage cope/ high resilience, and disengage cope/ low resilience). The high cope/ low resilience and disengage cope/ low resilience groups had significantly higher general perceived stress than the remaining groups. No significant group differences were noted in relation to daily hassles. Jointly addressing coping and resilience may be beneficial on the perceived stress experienced in autistic adults. The use of coping-resilience profiles may also allow for the personalization of stress management and support options in the autistic adult population.