The impact on Iranian mothers and fathers who have children with an autism spectrum disorder

Gender differences in predictors of quality of life for parents of children with Autism Spectrum disorder in Saudi Arabia

PURPOSE

Few researchers have examined gender differences in the quality of life (QoL) of parents of children with autism spectrum disorder (ASD) in diverse cultural contexts. The purpose of this study was to identify how ASD severity, affiliate stigma, perceived social support, family functioning, and coping strategies differentially predict the QoL of mothers and fathers of children with ASD in Saudi Arabia.

DESIGN AND METHODS

Based on a cross-sectional research design, data were gathered between April and July 2023 from a convenience sample of 376 parents (220 mothers and 156 fathers) of children with ASD in Saudi Arabia. Welch's t-test and regression were used to achieve the study purpose.

RESULTS

Mothers of children with ASD reported lower QoL, perceived social support, and family functioning than fathers. Mothers relied on emotion-focused coping strategies, whereas fathers used problem-focused coping strategies. Furthermore, affiliate stigma, perceived social support, and family functioning significantly predicted the QoL of mothers and fathers of children with ASD. However, the severity of ASD affected only the QoL of the mothers. Problem-focused coping significantly predicted fathers' QoL but not mothers' QoL.

CONCLUSIONS

The results highlight gender differences in the factors that predict the QoL of parents of children with ASD in Saudi Arabia.

PRACTICE IMPLICATIONS

Healthcare professionals should consider parents' gender when providing support and interventions to improve parental QoL.

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.

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.

The Relation of Parental Expressed Emotion, Parental Affiliate Stigma, and Typically-developing Sibling Internalizing Behavior in Families with a Child with ASD

Caregivers of children with autism spectrum disorder (ASD) experience greater stress, expressed emotion (EE), and affiliate stigma than caregivers of children without ASD. Siblings of children with ASD often experience greater negative functioning than siblings of individuals without ASD. The current study found significant interrelations among symptom severity and externalizing behavior in children with ASD; parental stress, affiliate stigma, and EE; and TD sibling internalizing behavior. In addition, certain subcomponents of affiliate stigma predicted unique variance in EE and TD sibling internalizing behavior. Findings may increase understanding of psychosocial functioning in families with children with ASD and allow clinicians to improve outcomes for all family members. Limitations of the study included self-report data, limited sample diversity, and a cross-sectional design.

Social, Community, and Cultural Factors Associated with Parental Stress in Fathers and Mothers

Parenting stress is a key factor in predicting the quality of parent−child relationships and child development outcomes. Previous research tends to focus on examining individual factors contributing to parental stress, with minimal attention to other important contextual factors that may affect parenting. This study examines the issue from a broader ecological perspective by investigating social, cultural, and community factors associated with parental stress in a community sample of economically active fathers and mothers in Hong Kong. A secondary analysis was conducted using the data from the 2017 Family Survey, a territory-wide household survey conducted in Hong Kong. The data of the current study included a sub-sample of 736 working-class parents (48.4% males and 51.6% females). The mean age of fathers and mothers was 50.99 (SD = 11.2) and 48.68 (SD = 10.34) years, respectively. Mothers reported significantly higher levels of parental stress than fathers, t = −4.241, p < 0.001. Different social, cultural, and community factors were associated with parental stress for fathers and mothers. Strong endorsement of traditional family values (B = −0.23, p = 0.032) and frequent practice of filial piety (B = −0.005, p = 0.019) reduced parental stress in fathers. Additionally, fathers who perceived formal support as effective scored higher levels of parental stress, B = 0.20, p < 0.001. For mothers, informal social support from family members was the only social predictor for reduced parental stress (B = −0.14, p < 0.001) among all the other contextual variables. Community support to reduce parental stress in working parents should address the respective risk factors for fathers and mothers.

Parental Stress of Children with Autism Spectrum Disorder During the Coronavirus Pandemic (COVID-19): Experience from Serbia

OBJECTIVE

Taking care of children with autism spectrum disorder (ASD), as of children with other developmental disorders, is associated with greater parental stress. The aim of this study was to determine the prevalence and impact of integrative and co-morbid ASD-related symptoms on parental stress levels during the COVID-19 pandemic at four time points. Testing was performed during significant changes related to the state of the COVID-19 pandemic in Serbia.

METHODS

The research sample included 67 parents of children with ASD 4 to 7 years and 6 months of age. The Autism Parenting Stress Index, Gilliam Autism Rating Scale - Third Edition, diagnostic criteria for ASD from DSM-5 and Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition were used to assess the tested abilities.

RESULTS

Core behavior (problems of social development and communication skills) as well as co-morbid behaviors related to ASD (tantrums, aggressive behavior, self-injurious behavior and difficulties with transitions) caused the highest degree of parental stress. Post hoc tests that used Bonferroni correction found that parental stress caused by basic and co-morbid behaviors gradually decreased from first to fourth measurement, respectively. Sleep and toilet training problems, as well as co-morbid physical problems, caused the greatest degree of parental stress during the first measurement. Measuring total parental stress caused by integrative and co-morbid symptoms related to ASD showed that it was at the highest level during the first measurement, decreased during the second measurement and remained unchanged during the third and fourth measurements.

CONCLUSION

Time, as a repeating factor, during the COVID-19 pandemic has an effect on lowering the levels of parental stress caused by all examined ASD-related domains. These results may be useful in creating individual programs to support parents of children with ASD during the COVID-19 pandemic.

Parental stress and dyadic adjustment among parents of children with ASD: Moderating effects of dyadic coping and perceived social support

BACKGROUND

Previous studies examining the association between child behavior problems and parental stress have reported mixed results.

AIM

This study aimed to explore the associations between child behavior problems and parental stress as well as parental stress and dyadic adjustment, and the moderating roles of stress communication, perceived partner supportive dyadic coping, and perceived social support in the relationship between parental stress and dyadic adjustment.

METHODS AND PROCEDURES

Data were derived from 233 parents with at least one child with ASD from Iran.

OUTCOMES AND RESULTS

The results demonstrated that child behavior problems were positively associated with parental stress whereas parental stress was negatively associated with dyadic adjustment. Furthermore, stress communication, perceived partner supportive dyadic coping, and perceived social support moderated the relationship between parental stress and dyadic adjustment.

CONCLUSIONS

The current findings may attract the attention of clinicians and professionals who work with parents of children with ASD on the effect of stress and how to manage stress on these parents' dyadic adjustment.

Caregiver strain and its predictors among parents of autistic children: a cross-sectional study

Objective: This study estimates the frequency and predictors of caregiver strain (CGS) among parents of autistic children.Methods: Demographic details and CGS were collected through a validated tool from 403 parents of autistic children in Karachi, Pakistan. Regression modelling was performed to report associations between social, behavioural, and communication problems and socioeconomic predictors of CGS. Results were reported using adjusted beta-coefficients with 95% confidence intervals.Results: In total, 88.3% of the parents reported moderate to severe CGS. A high family income (β = -4.31, 95% CI -7.55, -0.11), and caregiver's higher level of education (β = -4.73, 95% CI -8.84, -0.61), along with care-recipient age group (β = -9.35, 95% CI -15.17, -3.52) significantly predicted lower CGS. Diagnosis of more than 5 years (β = 7.57, 95% CI 2.36, 12.79), tendency to self-harm (β = 10.75, 95% CI 6.62, 14.88), and social withdrawal in the care-recipient (β = 4.56, 95% CI 1.68, 7.44) were significantly associated with higher CGS.Conclusion: Parents of children on the autistic spectrum suffer from high CGS. There is a need to introduce tailored parenting interventions at the individual and community levels to help parents reduce the CGS, ultimately benefiting their child.

Exploring challenges and support structures of mothers with children with Autism Spectrum Disorder in the United Arab Emirates

BACKGROUND

Mothers with children with ASD, often being primary caregivers, experience high levels of parenting stress and hold essential information about their children's wellbeing. There is however lack of information about their experiences in the UAE.

AIMS

The study aims to explore challenges and support structures of mothers with children with ASD in the UAE.

METHODS AND PROCEDURES

17 expat mothers (Age _range = 33-58 years) with a child with ASD were interviewed about their experiences with diagnoses, therapeutic interventions, support networks, and the pandemic.

OUTCOMES AND RESULTS

Thematic analysis showed that initially most mothers struggled with accessing information to seek correct diagnoses, admission in mainstream international schools with typically developing children, and finding appropriate therapeutic services. Several mothers narrated experiences of not receiving optimum support from their partners, feeling rejected from extended family members, and facing hardships during the pandemic. Majority however appeared to be extremely satisfied with support groups where they felt heard and exchanged experience-based information crucial for children's wellbeing.

CONCLUSIONS AND IMPLICATIONS

Findings highlight the need for the government to facilitate centralized channels of information for expat parents with children with developmental disabilities, formalizing more support groups for mothers in the UAE, and increasing knowledge about autism to decrease biases.

Internalization of stigma among parents of children with autism spectrum disorder in Nigeria: a mixed method study

Background

Autism Spectrum disorder (ASD) has uniquely stigmatizing aspects because children with ASD have no physical markers of their condition. Parents are usually blamed and judgment from others is often internalized (felt stigma).

Aim

This study was conducted to determine knowledge about ASD, negative experiences (enacted stigma), internalization of stigma (felt or self stigma) and its correlates among parents of children with ASD in Lagos, Nigeria.

Methods

This was a cross-sectional study of 230 parents in Lagos, Nigeria employing mixed-method data collection methods. Quantitative data were collected using a structured interviewer-administered questionnaire and analyzed with Epi- Info™ version 7.0 statistical package. Data were summarized with proportions, mean and standard deviation. Chi square and Spearman’s correlation tests were done, and the level of significance was pre-determined at 5% (p < 0.05). In-depth interviews were also conducted among six parents to further explore the topic. The interviews were analyzed narratively.

Results

The proportion of mothers and fathers were 175 (76.1%) and 55 (23.9%) respectively. The mean age of respondents was 42 ± 8.5 years. Overall knowledge of ASD was very poor as only 3(1.3%) had good knowledge. Overall, 122(53%) usually had negative experience of parenting a child with ASD (enacted stigma), mothers (17.1%) more than fathers (9.1%). Majority 192(83.5%) internalized stigma. There was a low–moderate correlation between ‘enacted’ stigma and ‘internalized’ stigma (ρ- 0.400, p < 0.001). From in-depth interviews, many parents revealed that their child’s condition had negative effects on the family. Many also recounted negative experience of stigma.

Conclusion

Overall, parents of children with ASD had poor knowledge of the condition. Majority internalized stigma and this increases with negative treatment from others. Parents should be properly educated about ASD. Community-based education to increase awareness about ASD in addition to encouraging people to show empathy and reduce stigmatizing behaviour towards parents of children with ASD are recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00687-3.

The Actor-Partner Effects of Parenting Stress on Quality of Life Among Parents of Children with ASD: The Mediating Role of Mental Quality of Life

The present study investigated the actor-partner effects of parenting stress (PS) on quality of life (QoL) among parents (96 couples) of children with autism spectrum disorder (ASD). Data were collected using the QoL Scale and the PS Index. Structural equation modeling was also utilized to test the hypothesis. The results revealed the effects of PS in each parent on mental QoL of that parent. Maternal PS further shaped physical QoL in mothers. However, PS in one parent did not influence QoL of his or her partner. Accordingly, mental QoL had a mediating role between PS and physical QoL. It was ultimately suggested to take account of QoL among parents in addition to the treatment of children with ASD.

Social support and post-crisis growth among mothers of children with autism spectrum disorder and mothers of children with down syndrome

BACKGROUND

Raising a child with special needs challenges mothers in complicated ways, yet, alongside these difficulties, there is evidence for maternal post-crisis growth. Social support is one element that may contribute to growth.

AIMS

This study explores the relationship between social support and post-crisis growth, examines type of disability as a mediating variable between support and growth, and, looks at the relations between subtypes of support and growth.

METHODS & PROCEDURES

Participants included 99 mothers of children with Autism Spectrum Disorder (ASD) and 119 mothers of children with Down Syndrome (DS). Mothers completed three self-report questionnaires: demographic, Multidimensional Scale of Perceived Social Support, and the Stress-Related Growth Scale.

RESULTS

Social support was found to predict maternal post-crisis growth with type of disability serving as a mediating variable between them, such that social support contributes to post-crisis growth only among mothers of children with ASD. In addition, results revealed various correlations between types of support and types of growth.

CONCLUSIONS & IMPLICATIONS

The findings indicate that compared to DS, characteristics of ASD may contribute to less maternal post-crisis growth, and that social support serves as an important predictor for growth in this group. Finding ways to increase social support for mothers of children with ASD thus gains additional importance.

Perspectives on Inclusive Education of Preschool Children with Autism Spectrum Disorders and Other Developmental Disabilities in Iran

Background: Iranian children with disabilities invariably attend special schools and many may be excluded from education entirely. Information on preschool education is limited but probably mirrors the situation in schools. There is a lack of information in terms of parental preferences for schooling and teachers’ experiences of inclusion in Iran. Method: Two feasibility studies were undertaken; one with 89 parents of children with autism or intellectual disabilities, and another with the head teachers of two private kindergartens. Results: Two-thirds of parents favored inclusive schools; most parents whose children had autism or were verbally proficient were in favor of their child attending ordinary schools, even if their child had been placed in a specialist preschool facility. The head teachers justified inclusion in terms of children’s rights but identified three main challenges: coping with the diverse level of functioning, the need for special devices and training of teachers, and challenging the negative reactions of parents of non-disabled children. Conclusions: Further exploration of the views of those who have experienced inclusion would further challenge existing practices. Moreover, the training and preparation of teachers is key to reforming schools. However, wider social values and beliefs towards disabilities also need to change.

Experiences of Inner-City Fathers of Children With Chronic Illness

We aim to explore the experiences of fathers from inner-city families caring for children affected by chronic health conditions or disabilities. A systematic scoping review was conducted using the Arskey and O'Malley framework. Fourteen of the 5114 articles were included in the full review and were qualitatively evaluated in terms of stressors, resources, perception, coping, and adaptation according to the Double ABCX model. Stressors included financial strain and health care access barriers. Resources ranging from immediate to extended family members depended on ethnicity. Fathers' perceptions of their primary caregiver roles depended on ethnicity in the context of cultural gender norms. While inner-city fathers desired information about their children's health, some were uncomfortable asking physicians. They had a higher risk for coping difficulties and maladaptation, including depression. We highlight a need for pediatricians to advocate for additional resources to provide comprehensive care for inner-city fathers caring for their children with chronic health conditions or disabilities.

Parents' impaired emotion recognition abilities are related to children's autistic symptoms in autism spectrum disorder

OBJECTIVE

We aimed to explore whether parents of children with autism spectrum disorder (ASD) had impaired emotion recognition abilities and whether this deficit was related to their children's autistic symptoms.

METHODS

The autistic symptoms of 31 ASD children were assessed using the Autism Diagnostic Interview-Revised (ADI-R). Fifty parents of ASD children and 34 parents of typically developing (TD) children completed an emotion recognition task (ERT).

RESULTS

The numbers of correct ERT responses were lower for parents of ASD children than for parents of TD children with respect to recognizing sadness, disgust, fear, and all emotions (P=0.01, 0.04, 0.02, and 0.00, respectively). Controlled for parental age, gender, and the intelligence quotients of both the parents and children, a negative correlation was found between the total number of correct ERT responses for parents of ASD children and these children's "restricted, repetitive, and stereotyped patterns of behavior" scores on the ADI-R (r=-0.32; P=0.03).

CONCLUSION

Parents of ASD children showed impaired emotion recognition abilities compared with parents of TD children. This parental deficit in emotion recognition ability was related to the autistic symptoms of ASD children.

« Avoir un enfant différent dans un pays où on est différent ». Une étude des familles immigrées en Norvège

Cadre de la recherche : En Norvège, vivre avec un enfant ayant des problèmes de santé est une réalité pour de nombreux parents et demande une adaptation de toute la famille ; cela peut être d’autant plus problématique pour des parents issus de l’immigration.

Objectifs : Le présent article vise à comprendre comment les familles issues de différents types d’immigration gèrent le suivi de l’enfant ayant des besoins spécifiques.

Méthodologie : Les données sont issues d’une recherche qualitative basée sur vingt-sept entretiens individuels semi-directifs et trois entretiens de groupe avec des parents immigrés ou issus de l’immigration. L’analyse inductive se fonde sur l’analyse de contenu des entretiens.

Résultats : Vivre avec un enfant ayant des besoins spécifiques exige une redéfinition de l’investissement et des rôles de chacun des parents. On note, en effet, des stratégies conjugales et parentales qui prennent forme dans un rapport de genre marqué à la fois par des pratiques de changement et de reproduction. Pour les familles immigrées ayant un enfant aux besoins spécifiques, la question du travail aussi bien pour les hommes que pour les femmes est centrale tant elle montre la nécessité des bricolages, à la fois pour l’adaptation au mode de vie du pays d’accueil et pour sortir de « la famille soignante », où l’enfant est au centre des préoccupations.

Conclusion : Les relations sociales (notamment par le travail ou par le maintien d’un réseau d’amis ou de la famille élargie) ainsi que le soutien apporté par les services médicosociaux restent des ressources précieuses pour faire face aux défis qu’entraînent le handicap ou la maladie chronique de l’enfant.

Contributions: L’étude, réalisée en collaboration avec Lisbeth Gravdal Kvarme, est financée par The Research Council of Norway, dans le cadre du projet « Ethnic differences in labour market participation, health and sickness absence among parents caring for disabled or chronically ill children » ( n o 227022/H20).

Risk and Protective Factors in the Lives of Caregivers of Persons With Autism: Caregivers' Perspectives

PURPOSE

The purpose of this descriptive exploratory study is to understand the experience of being a caregiver of a person with autism spectrum disorder (ASD) in the light of the resilience theory.

METHODS

Qualitative data were collected as a part of a larger quantitative study. Ninety-three caregivers completed this qualitative study and responded to the two open-ended questions. In the parent study, subjects were recruited by convenience sampling from the Interactive ASD Network (IAN).

FINDINGS

The identified categories appeared to reflect three distinct categories consistent with the resilience theory, labeled as follows: risk factors, protective factors, and overlapping factors.

PRACTICE IMPLICATIONS

These findings help to inform the planning of tailored interventions to enhance caregivers' resilience.

Access Barriers to Services by Immigrant Mothers of Children with Autism in Canada

Equal access for autism services remains suboptimal for diverse groups. In Canada, little is known about the barriers immigrant mothers face accessing services and support for their children with developmental disabilities. In this qualitative study, 21 immigrant mothers of children with Autism, from a diverse ethno cultural background, were interviewed in Toronto, Canada. We apply House’s (1981) four domains of social support to analyze findings. Structural support challenges, such as delays in diagnosis, fragmented and dispersed services were common, followed by instrumental challenges due to loss of social ties and stigma. Lack of expected support from partners, and negative perceptions of services, were identified as emotional and perceptive challenges. Focused attention is required to address inequalities within the context of current access pathways for autism.

A meta-synthesis on parenting a child with autism

BACKGROUND

The lifelong nature of autism in a child has deep implications on parents as they are faced with a range of challenges and emotional consequences in raising the child. The aim of this meta-synthesis was to explore the perspectives of parents in raising a child with autism in the childhood period to gain an insight of the adaptations and beliefs of parents toward autism, their family and social experiences, as well as their perceptions toward health and educational services.

METHODS

A systematic search of six databases (PubMed, EMBASE, PsychInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects [DARE]) was conducted from inception up to September 30, 2014. Full-text English articles of qualitative studies describing parents' perceptions relating to the care of children younger than 12 years of age and diagnosed with a sole disorder of autism were included.

RESULTS

A total of 50 eligible articles were appraised and analyzed, identifying four core themes encompassing all thoughts, emotions, and experiences commonly expressed by parents: 1) The Parent, 2) Impact on the Family, 3) Social Impact, and 4) Health and Educational Services. Findings revealed that parents who have a child with autism experienced multiple challenges in different aspects of care, impacting on parents' stress and adaptation.

CONCLUSION

Health care provision should be family centered, addressing and supporting the needs of the whole family and not just the affected child, to ensure the family's well-being and quality of life in the face of a diagnosis of autism.

Investigating Parenting Stress across Pediatric Health Conditions - A Systematic Review

The stress parenting responsibilities place on parents increases in situations involving pediatric illness, and therefore can potentially interfere with the normal family life. The present review examines sources of parenting stress across a wide spectrum of illnesses, using three illness groups as exemplars: Congenital heart disease, pediatric cancer, and Autism Spectrum Disorder. A systematic review of the literature using PubMed, CINAHL, Scopus, and PsycINFO databases yielded 66 observational studies investigating sources of parenting stress in parents of young children with congenital heart defects, cancer, and Autism Spectrum Disorder. Quality assessment, using the STROBE and COREQ quality indexes, was further conducted for the included studies. Stressors were categorized, and then analyzed in light of the diagnostic characteristics of the populations in focus. Findings indicate that parents across all illness groups experience increased levels of parenting stress. Several categories were identified in accordance to the parenting stress model as follows: illness-related factors, parental factors, child characteristics, familial factors, and social factors. Further analysis has revealed distinct parental concerns within the groups deriving from the diagnostics, care demands, or social responses specific to each group. Theoretical and practical implications for Family-Systems Nursing Practice were further discussed. Future research and assessment of parenting stress should account for the illness course and address family needs within the specific context of the illness.

Family wellbeing of individuals with autism spectrum disorder: A scoping review

Families play an important role in supporting individuals with autism spectrum disorder across the lifespan. Indicators of family wellbeing can help to establish benchmarks for service provision and evaluation; however, a critical first step is a clear understanding of the construct in question. The purpose of the current scoping review was to (a) summarize current conceptualizations and measurements of family wellbeing, (b) synthesize key findings, and (c) highlight gaps and limitations in the extant literature. A final review of 86 articles highlighted the difficulty of synthesizing findings of family wellbeing in the autism spectrum disorder literature due to varied measurement techniques and the limited use of a common theoretical direction. Considerations for future research are presented with an eye toward policy relevance.