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Lagang-Buenaventura MKC, Ang-Nolasco VDC. Needs and Coping during the COVID-19 Pandemic among Families of Children with Autism Spectrum Disorder in a Government Tertiary Hospital. ACTA MEDICA PHILIPPINA 2024; 58:152-162. [PMID: 38882907 PMCID: PMC11168959 DOI: 10.47895/amp.v58i7.6331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background The COVID-19 pandemic has affected the well-being of children with Autism Spectrum Disorder (ASD) and their families. The core deficits of the condition and increased parental stress during this time made them more vulnerable. Objectives This study aims to explore how the pandemic has affected these families by identifying their needs and capabilities in order to provide support. Methods A total of 227 parents of children with ASD completed an online survey consisting of items on socio-demographics, family needs, and coping strategies. Descriptive statistics were used and t-test and ANOVA/Kruskal Wallis were used to determine the relationship between parent and child factors with needs and coping. Results Needs for Information, Community Services, and Finances are the top categories while the greatest identified need during this pandemic was for financial assistance. Religiosity, Problem-Solving, and Cognitive Reappraisal were the widely used coping strategies by the parents. Fathers, younger children, daughters with ASD, and having more than one child with ASD showed significant association with needs. Parents with primary and tertiary education were associated with use of the cognitive reappraisal strategy and those with jobs were associated with substance use. Conclusion Families of children with ASD have multiple needs during this pandemic, from autism-specific information and services, to more generic concerns such as financial assistance. Despite these challenges, these families have positive strategies in place to facilitate coping mechanisms.
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Affiliation(s)
- Marie Khatrina C Lagang-Buenaventura
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Victoria Dominique C Ang-Nolasco
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
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Katalifos A, Elsabbagh M, Yusuf A, Yamaguchi S, Scorah J, Wright N, Steiman M, Shih A, Shikako K. Alignment of Canada's COVID-19 policy response with barriers and facilitators for coping reported by caregivers of youth with developmental delays, disorders, and disabilities. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1308062. [PMID: 38590546 PMCID: PMC10999642 DOI: 10.3389/fresc.2024.1308062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
Introduction The UNICEF-WHO Global Report on Developmental Delays, Disorders, and Disabilities is an ongoing initiative aimed at increasing awareness, compiling data, providing guidance on strengthening health systems, and engaging country-level partners. Data from its caregiver survey assessing impacts of the COVID-19 pandemic showed that half of youths with developmental delays and disabilities (DDDs) and their caregivers struggled to cope, with a significant portion reporting a lack of supports and difficulty managing the worsening of the child's symptoms in isolation. Governments created service strategies supporting vulnerable groups. Little is known about the alignment between COVID-19 policies for persons with disabilities and their lived experiences. Contextualizing caregivers' experiences can promote the development of tailored public supports for these families following a public health crisis. Methods Online survey data were collected from June-July 2020, leading to a convenience sample of caregivers of youth with DDDs across Canada. Respondents answered two open-ended questions regarding challenges and coping strategies during the pandemic. We conducted a thematic analysis of responses using inductive coding on NVivo software. Overarching codes derived from the dataset were contextualized using an analysis of provincial policies published during the pandemic. Parallels with these policies supported the exploration of families' and youths' experiences during the same period. Results Five hundred and seventy-six (N = 576) participants answered open-ended questions. Barriers to coping included family mental health issues, concerns about the youths' regression, challenges in online schooling, limited play spaces, and managing physical health during quarantine. Environmental barriers encompassed deteriorating family finances, loss of public services, and a lack of accessible information and supports. In contrast, caregivers reported coping facilitators, such as family time, outdoor activities, and their child's resilience. Environmental facilitators included community resources, public financial supports, and access to telehealth services. Few COVID-19 policies effectively addressed caregiver-identified barriers, while some restrictions hindered access to facilitators. Conclusion Prioritizing needs of families of youths with DDDs during public health emergencies can significantly impact their experiences and mental health. Enhancing financial benefits, providing telehealth services, and creating inclusive public play spaces are priority areas as we navigate the post-pandemic landscape.
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Affiliation(s)
- Anna Katalifos
- Azrieli Centre for Autism Research, Montreal Neurological Hospital-Institute, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Mayada Elsabbagh
- Azrieli Centre for Autism Research, Montreal Neurological Hospital-Institute, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Afiqah Yusuf
- Azrieli Centre for Autism Research, Montreal Neurological Hospital-Institute, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Sakiko Yamaguchi
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Julie Scorah
- Azrieli Centre for Autism Research, Montreal Neurological Hospital-Institute, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Nicola Wright
- Department of Psychology, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Mandy Steiman
- Azrieli Centre for Autism Research, Montreal Neurological Hospital-Institute, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andy Shih
- Scientific Affairs, Autism Speaks, New York, NY, United States
| | - Keiko Shikako
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Fowler K, O’Connor C. ‘I just rolled up my sleeves’: Mothers’ perspectives on raising girls on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:275-287. [DOI: 10.1177/1362361320956876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Little previous research has elucidated the everyday experiences of autistic girls or their families. This study used qualitative in-depth interviews to explore mothers’ experiences of the diagnosis, presentation and impact of caring for a daughter with autism. Nineteen women with autistic daughters (aged between 7 and 18) participated in the research, which took place in Ireland. Thematic analysis identified six themes: What’s Going On?; Road to Acceptance; Beyond the Stigma of Autism; Autism: Like a Girl; Mothers Holding It All Together; and Mothers Roll Up Their Sleeves. The analysis suggests that the path of autism in girls in Ireland is marked by diagnostic delays, social stigma, interpersonal difficulties, mental health comorbidities and parental stress. However, these challenges were offset by the resilience of mothers, buttressed by pride in their daughters and support from other women. Results will inform the development of policy and practice that is sensitive to the lived realities of autistic girls and their families. Lay abstract Autism in boys has been well researched but very little is known about the everyday experiences of autistic girls or their families. Mothers’ views and insights can be very helpful in increasing knowledge around the unique demands of raising a daughter with autism. This study conducted interviews with Irish mothers to examine their own experiences regarding (a) getting an autism diagnosis for their daughter, (b) their daughters’ personal characteristics and (c) the impact of caring for a daughter with autism. The study suggests that the route to an autism diagnosis for girls in Ireland is made more difficult by delays and missed diagnoses, and often followed by inadequate supports. Mothers described autistic girls as presenting with social challenges and mental health difficulties. Many mothers experienced judgement from other parents and family members, acute stress and mental health struggles. However, these challenges were offset by mothers’ resilience, pride in their daughters and support from other women. The findings of this study highlight the importance of specific support for autistic girls and their families.
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Parker ML, Diamond RM, Del Guercio AD. Care Coordination of Autism Spectrum Disorder: A Solution-Focused Approach. Issues Ment Health Nurs 2020; 41:138-145. [PMID: 31322982 DOI: 10.1080/01612840.2019.1624899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The expanding practice of multi-disciplinary care to address the complex nature of Autism Spectrum Disorder (ASD) suggests that there is a need for a means of coordinating care that transcends the disciplinary distinctions of relevant ASD treatment providers. As ASD services become more specialized, there is a growing need for effective care coordination with providers across the systems of care. Nursing professionals are ideally qualified to support families affected by ASD, as they provide a necessary holistic lens of health and wellbeing to obtain the appropriate treatments. Solution-focused brief therapy has been applied to a growing number of clinical settings, indicating solution-focused techniques are applicable to the various contexts associated with ASD treatments. We provide a case presentation to demonstrate a solution-focused approach to address ASD-related concerns within the family that are generalizable to coordination of care.
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Affiliation(s)
- M L Parker
- Department of Family and Child Sciences, Florida State University, Tallahassee, Florida, USA
| | - Rachel M Diamond
- Department of Couples and Family Therapy, Adler University, Chicago, Illinois, USA
| | - Ashley D Del Guercio
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
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D'Mello M, Devi L, Rent P. Stress and burden among parents of students in special schools of Mangaluru: A cross-sectional study. MULLER JOURNAL OF MEDICAL SCIENCES AND RESEARCH 2019. [DOI: 10.4103/mjmsr.mjmsr_24_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wigander H, Öjmyr-Joelsson M, Frenckner B, Wester T, Nisell M. Impact of Low Anorectal Malformation on Parenting Stress: A Mixed-Method Study. J Pediatr Nurs 2018; 42:e45-e51. [PMID: 29778302 DOI: 10.1016/j.pedn.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/30/2018] [Accepted: 05/05/2018] [Indexed: 12/29/2022]
Abstract
UNLABELLED The purpose of this study was to investigate parenting stress among parents of children with low ARM. STUDY AIMS 1) Compare parenting stress among parents of children with low ARM, with parents of healthy children using questionnaires. 2) Identify subscales within the questionnaire which needed to be further explored. 3) Use semi-structured interviews with parents of children with low ARM, to explore parenting stress and to explain, expand and or support the quantitative findings. DESIGN AND METHODS An explanatory sequential mixed methods design was used in this follow up study. The parents completed the Swedish Parenthood Stress Questionnaire (SPSQ), semi-structured interviews were conducted. RESULTS Fifteen mothers and 13 fathers of children with low ARM age 8-18, returned completed questionnaires. A control group of 17 mothers and 6 fathers of healthy children age 8-18 that had visited the hospital for a minor procedure was recruited for comparison purposes. There were no significant differences found between index group and controls except in the subscale Incompetence, where parents of children with low ARM reported lower levels of stress compared to controls. Nine semi-structured interviews were conducted with parents of children with low ARM. Qualitative content analysis was used and revealed three themes - Communication between parents, Expectations of parenthood, and Challenges concerning parenthood. CONCLUSIONS Parents of children with low ARM did not report high levels of stress. When interviewed, they told about earlier experiences of emotional stress, feelings of guilt, and chaos at the time the child was born and during infancy.
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Affiliation(s)
- Helena Wigander
- Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden; Division of Pediatric Surgery, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
| | - Maria Öjmyr-Joelsson
- Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden; Division of Pediatric Surgery, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Björn Frenckner
- Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden; Division of Pediatric Surgery, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Tomas Wester
- Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden; Division of Pediatric Surgery, Karolinska University Hospital, Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Margret Nisell
- The Swedish Red Cross University College, Department of Health Sciences, Huddinge, Sweden; Department of Women's and Children's Health, Division of Child- and Adolescent Psychiatry, Karolinska Institutet, Stockholm, Sweden
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Navot N, Jorgenson AG, Webb SJ. Maternal experience raising girls with autism spectrum disorder: a qualitative study. Child Care Health Dev 2017; 43:536-545. [PMID: 28464352 PMCID: PMC5993544 DOI: 10.1111/cch.12470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/23/2017] [Accepted: 04/03/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND A growing line of research has sought to characterize the different presentations of autism spectrum disorder (ASD) among boys and girls. Much less is known about maternal experience and mother-child relationship in children with ASD based on child gender. The present qualitative study aimed to investigate the mother-daughter relationship from the perspective of mothers who are raising girls with ASD with normal intelligence and functional verbal communication. METHODS Eleven in-depth interviews were conducted with mothers of girls with ASD, ages 10-19 years. Data were analysed in an interactive process commonly used in naturalistic inquiry. Results provide insight into the unique maternal experience of raising a daughter with ASD. RESULTS Mothers reported a sense of exclusion from the neurotypical population and male-dominant ASD population and transformation in relationship. Themes identified were skepticism and delayed diagnosis, disbelief from others, lack of information about girls with ASD, higher social demands in adolescence, puberty challenges around hygiene, disappointment about physical appearance, vulnerability in relationships and worries about future functioning. The mother-daughter relationship started with an early expectation of a close and intimate relationship that then underwent a transformation, which challenged maternal competence, reshaped expectations and created a different bond between mother and daughter. CONCLUSIONS The findings in this qualitative study highlight the impact of gender on the maternal experience of raising a daughter with ASD and contribute to a better understanding of the needs of both mothers and daughters. These results can help providers support the mother-daughter dyad by recognizing gender-specific challenges.
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Affiliation(s)
- N Navot
- Department of Child and Adolescent Psychiatry, Ziv Medical Center, Safed, Israel
- Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA, USA
| | - A G Jorgenson
- Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA, USA
| | - S J Webb
- Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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Rumburg TM, Lord JH, Savin KL, Jaser SS. Maternal diabetes distress is linked to maternal depressive symptoms and adolescents' glycemic control. Pediatr Diabetes 2017; 18:67-70. [PMID: 26712240 PMCID: PMC4927411 DOI: 10.1111/pedi.12350] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/03/2015] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Mothers of youth with type 1 diabetes experience increased levels of stress and depression related to the burden of diabetes management, but the concept of diabetes distress, or distress linked specifically to diabetes and its management, has not been applied to mothers. The current study examined diabetes distress in relation to maternal depressive symptoms and adolescents' glycemic control. RESEARCH DESIGN AND METHODS Mothers of youth with type 1 diabetes (age: 10-16) completed a measure of depressive symptoms and diabetes distress as part of a screening questionnaire. Adolescents' glycosylated hemoglobin (HbA1c) was obtained from medical records. RESULTS Mothers' diabetes distress was strongly related to maternal depressive symptoms, and relationship-related diabetes distress was significantly associated with adolescents' HbA1c. In multivariate analyses, maternal depression was the only significant predictor of glycemic control. CONCLUSIONS Given the links between mothers' diabetes distress, maternal depressive symptoms, and adolescents' glycemic control, diabetes distress may be important to consider when targeting both maternal and adolescent adjustment to type 1 diabetes.
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Affiliation(s)
- Tamara M. Rumburg
- Vanderbilt University, Department of Pediatrics, Nashville, TN 37232
| | - Jadienne H. Lord
- Vanderbilt University, Department of Pediatrics, Nashville, TN 37232
| | - Kimberly L. Savin
- Vanderbilt University, Department of Pediatrics, Nashville, TN 37232
| | - Sarah S. Jaser
- Vanderbilt University, Department of Pediatrics, Nashville, TN 37232
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Examining bidirectional relationships between parenting and child maladjustment in youth with autism spectrum disorder: A 9-year longitudinal study. Dev Psychopathol 2016; 29:1199-1213. [PMID: 28031057 DOI: 10.1017/s0954579416001243] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Longitudinal bidirectional effects between parents and children are usually studied in samples of typically developing children, but remain understudied in families with a child with autism spectrum disorder. This three-wave longitudinal study examined how parents and children with autism spectrum disorder influence one another, relying on parent reports of parenting behaviors and children's problem behaviors across 9 years, in a sample of 139 youngsters (M age Time 1 = 10.2 years, 83% boys). Cross-lagged analyses indicated that children's externalizing problems at Time 1 predicted negative controlling parenting 6 years later (Time 2) that in turn predicted externalizing problems 3 years later (Time 3). Negative parental control at Time 1 also increased the risk for internalizing problems at Time 2. It was surprising that externalizing problems at Time 2 also predicted positive parental involvement at Time 3. Thus, although results indicate that externalizing problems generally elicit maladaptive reactions in parents, this study also suggests that parents adjust their way of reacting to externalizing child problems as their child reaches adolescence/emerging adulthood. Implications for future research on parenting dynamics in families with a child with autism spectrum disorder are discussed.
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