1
|
Tekola B, Kinfe M, Girma Bayouh F, Hanlon C, Hoekstra RA. The experiences of parents raising children with developmental disabilities in Ethiopia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:539-551. [PMID: 35757938 DOI: 10.1177/13623613221105085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT The experiences of parents raising children with developmental disabilities have been widely researched, although most of this research comes from Western, high-income countries. In comparison, little is known about the lived experiences of parents of children with developmental disabilities in low- and middle-income countries and in Africa in particular. We interviewed 14 mothers and 4 fathers in Addis Ababa and the rural town of Butajira to explore what life is like for parents caring for children with developmental disabilities in Ethiopia. Cultural and religious beliefs played a role in the types of delays or differences in their child's development that parents noticed early and the kinds of support they sought. Parents experienced stigma and lack of understanding from others. Their experiences regarding some of the challenges they faced such as lack of appropriate services varied based on where they lived (urban or rural). Single mothers especially were faced with multiple struggles including poverty, stigma, and lack of social support. Implications for future research and interventions that aim to increase knowledge about developmental disabilities, tackle stigma and improve the lives of children and their families are discussed.
Collapse
|
2
|
Sarrió-Colas L, Ferré-Grau C, Monteso-Curto P, Adell-Lleixà M, Albacar-Riobóo N, Lleixá-Fortuño M. The experiences of parents as caregivers of adolescents with mental illnesses, the impact of the crisis and the admission to a day hospital. Arch Psychiatr Nurs 2022; 37:45-51. [PMID: 35337438 DOI: 10.1016/j.apnu.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 12/11/2020] [Accepted: 06/11/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to analyze the caregiving experience of parents whose adolescent children with a mental illness require admission to a day treatment hospital for mental health services. METHOD The study used qualitative interpretative research methods. A total of 18 parents participated in the semi-structured interviews. Data were then transcribed and analyzed in accordance with established methods for the analysis of inductive thematic data. RESULTS Seven themes were identified: questioning an unseen disease, abnormal behavior, a long road, truancy and loss of parental authority, internalized stigma on admission, regaining the meaning of life and an uncertain future. DISCUSSION The experience of the parents was analyzed and various emotional, psychological and interpersonal barriers were found that influenced the help-seeking for the adolescent's treatment. IMPLICATIONS FOR PRACTICE Nursing interventions should be based on detecting barriers and validating the experience of parents with mentally ill adolescents.
Collapse
Affiliation(s)
- Lídia Sarrió-Colas
- Faculty of Nursing, Rovira i Virgili University, Campus Terres de l'Ebre, Tortosa, Spain; Fundation Pere Mata Terres de l'Ebre, Amposta, Spain.
| | - Carme Ferré-Grau
- Faculty of Nursing, Rovira i Virgili University, Campus Catalunya, Tarragona, Spain
| | - Pilar Monteso-Curto
- Faculty of Nursing, Rovira i Virgili University, Campus Terres de l'Ebre, Tortosa, Spain
| | - Mireia Adell-Lleixà
- Faculty of Nursing, Rovira i Virgili University, Campus Terres de l'Ebre, Tortosa, Spain; Hospital de la Santa Creu de Jesús-Tortosa, Spain
| | - Núria Albacar-Riobóo
- Faculty of Nursing, Rovira i Virgili University, Campus Terres de l'Ebre, Tortosa, Spain
| | - Mar Lleixá-Fortuño
- Faculty of Nursing, Rovira i Virgili University, Campus Terres de l'Ebre, Tortosa, Spain; Faculty of Nursing, Rovira i Virgili University, Campus Catalunya, Tarragona, Spain; Terres de l'Ebre Health Region, Tortosa, Spain
| |
Collapse
|
3
|
Calleja S, Kingsley J, Amirul Islam FM, McDonald R. Barriers to Accessing Healthcare: Perspectives from Autistic Adults and Carers. QUALITATIVE HEALTH RESEARCH 2022; 32:267-278. [PMID: 34906008 DOI: 10.1177/10497323211050362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Autistic adults have higher health needs compared to most, yet they continue to experience barriers to accessing appropriate healthcare. Presently, no qualitative research exists exploring these barriers which impact overall physical and mental health. We conducted a qualitative analysis in Victoria (Australia) of the perceived experiences of healthcare access for autistic adults (n = 9) and primary caregivers of autistic adults (n = 7). Specifically, a three-staged phenomenological approach was applied involving: (i) a communicative checklist, (ii) a health status survey and (iii) face-to-face interviews. Elements such as support, responsibilities and protective factors exhibited by caregivers, may impact healthcare access for autistic adults. Results indicate the need for further research exploring interdependent factors that impact healthcare access by caregivers, so evidence-based interventions can be developed to support caregivers in the future.
Collapse
Affiliation(s)
- Shenae Calleja
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jonathan Kingsley
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
- Centre of Urban Transitions, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Fakir M Amirul Islam
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Rachael McDonald
- Faculty of Health, Arts and Design, 3783Swinburne University of Technology, Hawthorn, VIC, Australia
| |
Collapse
|
4
|
Peltekova I, Yusuf A, Frei J, Savion-Lemieux T, Joober R, Howe J, Scherer SW, Elsabbagh M. Predictors of empowerment in parents of children with autism and related neurodevelopmental disorders who are undergoing genetic testing. Mol Genet Genomic Med 2021; 9:e1803. [PMID: 34668664 PMCID: PMC8606197 DOI: 10.1002/mgg3.1803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/29/2022] Open
Abstract
Background There is limited empirical data quantifying the utility of genetic testing for families of children with autism spectrum disorder (ASD) or related neurodevelopmental disorders (NDD). We assessed the utility of clinical chromosomal microarray analysis (CMA), defined by diagnostic yield and parental empowerment, in population‐based sample of parents of affected children; and explored child, family, and health services factors predictive of empowerment. Methods Participants were families of children undergoing diagnostic assessments, between 2016 and 2019. Diagnostic yield of CMA in affected children was determined. Parental empowerment was measured through adapted version of the Genetics Counseling Outcome Scale‐24. Parents completed questionnaires to capture child, family, and health service factors. Results The diagnostic yield of CMA was 2.8% for pathogenic variants. Parental empowerment was significantly correlated with family functioning and aspects of perceived family‐centeredness of care. The model accounted for 49.8% of the variation in parental empowerment, F (10,37) = 3.67, p = 0.002. After accounting for other predictors, parental perception of the provision of general information remained significantly associated with empowerment. Conclusion The informational needs of families play an important role in their empowerment during genetic testing. Meeting these needs and monitoring empowerment can aid genomic technologies integration in personalized healthcare for ASD/NDD.
Collapse
Affiliation(s)
| | - Afiqah Yusuf
- McGill University Health Centre, Montreal, Quebec, Canada.,Azraeli Centre for Autism Research, Montreal Neurologic Institute, Montreal, Quebec, Canada
| | - Jennifer Frei
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Ridha Joober
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jennifer Howe
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada.,McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Mayada Elsabbagh
- McGill University Health Centre, Montreal, Quebec, Canada.,Azraeli Centre for Autism Research, Montreal Neurologic Institute, Montreal, Quebec, Canada
| |
Collapse
|
5
|
Plummer T, Bryan M, Dullaghan K, Harris A, Isenberg M, Marquez J, Rolling L, Triggs A. Parent Experiences and Perceptions of Safety When Transporting Children With Autism Spectrum Disorder. Am J Occup Ther 2021; 75:14125. [PMID: 34780642 DOI: 10.5014/ajot.2021.041749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Motor vehicle accidents are the leading cause of unintentional deaths of children ages 1 and older, particularly children with health care needs. OBJECTIVE To explore family caregivers' experiences and current practices while transporting children diagnosed with autism spectrum disorder (ASD). DESIGN A concurrent nested mixed-methods approach was used to gain insight into caregiver experiences. SETTING Participants completed an online Qualtrics survey. PARTICIPANTS A convenience sample of 54 caregivers of children with ASD from 17 U.S. states. RESULTS Themes that emerged include sensory behaviors of children, education related to child passenger safety, and participation in the community. Statistically significant findings suggest a correlation between caregivers (n = 39) being less likely to participate in activities away from home if the child had attempted to elope (p = .013), displayed aggressive behaviors (p = .005), or demonstrated self-injurious behaviors (p = .001). CONCLUSIONS AND RELEVANCE The findings suggest a correlation between caregivers limiting the distance traveled during vehicular transportation and behavioral safety concerns. If caregivers must limit travel, they may refrain from accessing the community and engaging in leisure pursuits. What This Article Adds: The findings suggest that therapists who treat children with ASD should be familiar with child passenger safety restraints, particularly for elopement.
Collapse
Affiliation(s)
- Teresa Plummer
- Teresa Plummer, PhD, OTR/L, ATP, CEAS, CAPS, is Associate Professor, School of Occupational Therapy, Belmont University, Nashville, TN;
| | - Missy Bryan
- Missy Bryan, OTD, OTR/L, ATP, CPST, is Assistant Professor, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Katherine Dullaghan
- Katherine Dullaghan, OTD, OTR/L, is Occupational Therapist, FOX Rehab, Richmond, VA. At the time of the study, Dullaghan was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Abigail Harris
- Abigail Harris, OTD, is Occupational Therapist, Select Physical Therapy, Nashville, TN. At the time of the study, Harris was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Michaela Isenberg
- Michaela Isenberg, OTD, is Occupational Therapist, Arlington Medical Center, Fort Worth, TX. At the time of the study, Isenberg was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Jacqueline Marquez
- Jacqueline Marquez, OTD, is Occupational Therapist, Presbyterian Hospital-Rust Medical Center, Albuquerque, NM. At the time of the study, Marquez was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Lacy Rolling
- Lacy Rolling, OTD, is Occupational Therapist, South Valley Post Acute Rehab Center, Denver, CO. At the time of the study, Rolling was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| | - Autumn Triggs
- Autumn Triggs, OTD, is Occupational Therapist, HCA at Tristar Skyline Medical Center, Nashville, TN. At the time of the study, Triggs was Doctoral Student, School of Occupational Therapy, Belmont University, Nashville, TN
| |
Collapse
|
6
|
Halliwell N, Podvey M, Smith JD, Harris K, Sylvester L, DeGrace BW. Experience of Sleep for Families of Young Adults With Autism Spectrum Disorder. Am J Occup Ther 2021; 75:12672. [PMID: 34780630 DOI: 10.5014/ajot.2021.043364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Children with autism spectrum disorder (ASD) may experience sleep difficulties that worsen into adulthood and negatively influence both child and family, yet the experience is not well understood. Understanding the family's experience can inform occupational therapy providers, future research, and practice guidelines. OBJECTIVE To examine experiences surrounding sleep for families raising a young adult with ASD (YA-ASD). DESIGN Qualitative study in the phenomenological tradition of Moustakas (1994). Experienced researchers analyzed transcripts from in-depth, in-person interviews to triangulate data, distill themes, and construct the essence of family experience. Trustworthiness was established through member checking, audit trails, and epoché diaries that were maintained throughout data analyses. SETTING Community setting (large city in the northeastern United States). PARTICIPANTS People who self-identified as living in a family arrangement that included a YA-ASD age 15-21 yr, able to verbally participate in English. Families with children diagnosed with developmental disabilities other than ASD were excluded. RESULTS Six eligible families identified through volunteer sampling participated. The participants' sociodemographic diversity was limited across household income, education level, and ethnicity. All YA-ASD in this study were limited verbally and unable to contribute. Analyses of interview transcripts revealed five themes that form the essence of the families' experience surrounding sleep. CONCLUSIONS AND RELEVANCE Sleep issues for YA-ASD continue into adulthood and affect the entire family because of continuous co-occupation; occupational therapy support is therefore important for families of YA-ASD. The lack of effective evidence-based interventions supporting the YA-ASD population also reveals an area for growth. What This Article Adds: The results indicate the importance of addressing sleep for YA-ASD and their families in occupational therapy practice because of its considerable impact on family life.
Collapse
Affiliation(s)
- Nicole Halliwell
- Nicole Halliwell, DSc, OTR/L, is Assistant Professor, Department of Occupational Therapy, Monmouth University, West Long Branch, NJ, and Occupational Therapist, Kid Clan Therapy Center, Clifton, NJ. At the time of this study, Halliwell was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, and Occupational Therapist, The Phoenix Center, Nutley, NJ;
| | - Mara Podvey
- Mara Podvey, PhD, OTR, PMH-C, FAOTA, is Associate Professor, Department of Occupational Therapy, School of Health and Medical Sciences, Seton Hall University Interprofessional Health Sciences Campus, Nutley, NJ
| | - Julie D Smith
- Julie D. Smith, DSc, OTR/L, is Occupational Therapist, SoonerStart Early Intervention, Family Health Services, Oklahoma State Department of Health, Oklahoma City. At the time of this study, Smith was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Katelyn Harris
- Katelyn Harris, MOT, OTR/L, is Occupational Therapist, KidsCare Home Health, Denver, CO. At time of this study, Harris was Master's Student, Department of Rehabilitation Science, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Lorraine Sylvester
- Lorraine Sylvester, PhD, PT, is Professor Emeritus, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Beth W DeGrace
- Beth W. DeGrace, PhD, OTR/L, FAOTA, is Associate Professor, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| |
Collapse
|
7
|
Parent clinical trial priorities for fragile X syndrome: a best-worst scaling. Eur J Hum Genet 2021; 29:1245-1251. [PMID: 34163011 PMCID: PMC8385075 DOI: 10.1038/s41431-021-00922-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/19/2021] [Accepted: 06/02/2021] [Indexed: 02/03/2023] Open
Abstract
An expansion in the availability of clinical drug trials for genetic neurodevelopmental conditions is underway. Delineating patient priorities is key to the success of drug development and clinical trial design. There is a lack of evidence about parent decision-making in the context of clinical drug trials for genetic neurodevelopmental conditions. We assessed parents' priorities when making a decision whether to enroll their child with fragile X syndrome (FXS) in a clinical drug trial. An online survey included a best-worst scaling method for parents to prioritize motivating and discouraging factors for child enrollment. Parents were recruited through the National Fragile X Foundation and FRAXA. Sequential best-worst with conditional logit analysis was used to determine how parents prioritize motivating and discouraging factors about trial enrollment decisions. Respondents (N = 354) were largely biological mothers (83%) of an individual with FXS who ranged in age from under 5 to over 21 years. The highest motivating factor was a trial to test a drug targeting the underlying FXS mechanism (coeff = 3.28, p < 0.001), followed by the potential of the drug to help many people (coeff = 3.03, p < 0.001). Respondents rated requirement of blood draws (coeff = -3.09, p < 0.001), loss of access to the drug post trial (coeff = -3.01, p < 0.001), and drug side effects (coeff = -2.96, p < 0.001) as most discouraging. The priorities defined by parents can be incorporated into evidence-based trial design and execution to enhance the enrollment process.
Collapse
|
8
|
Courcy I, des Rivières-Pigeon C. 'We're responsible for the diagnosis and for finding help'. The help-seeking trajectories of families of children on the autism spectrum. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:40-57. [PMID: 32931031 DOI: 10.1111/1467-9566.13184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 06/17/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
This article focuses on parents' process of seeking help for their child when a diagnosis of autism spectrum disorder is made or suspected. The study was conducted with 18 parents of children aged 4-10 years in Quebec (Canada). A trajectory-network approach was applied in order to carry out an in-depth analysis of family help-seeking trajectories based on the relationships mobilised (or neglected) over time and on life course events that may have precipitated (or hindered) help-seeking actions. Semi-directed interviews based on a name generator were conducted. A qualitative analysis of the content of family narratives was done and followed by the production of a schematic representation of each families' help-seeking trajectory. The results identified four constitutive phases during which relationships within the family, within associations, or with health and social services or education professionals helped or hindered the help-seeking process. The results show the relevance of the proposed approach for analysing the help-seeking process and better supporting families of children on the autism spectrum.
Collapse
Affiliation(s)
- Isabelle Courcy
- Université du Québec à Montréal, Montréal, QC, Canada
- Centre de recherche et de partage des savoirs InterActions, CIUSSS Nord-de-l'Ile-de-Montréal, Montréal, QC, Canada
| | | |
Collapse
|
9
|
Whittingham K, McGlade A, Kulasinghe K, Mitchell AE, Heussler H, Boyd RN. ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder. BMJ Open 2020; 10:e034315. [PMID: 32819928 PMCID: PMC7440709 DOI: 10.1136/bmjopen-2019-034315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/04/2020] [Accepted: 06/08/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD. METHODS AND ANALYSIS We aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent-child interactions to improve early social reciprocity, while supporting parental mental health and the parent-child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent-infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs. ETHICS AND DISSEMINATION This protocol has been approved by the Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12618002046280).
Collapse
Affiliation(s)
- Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrea McGlade
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kavindri Kulasinghe
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Amy E Mitchell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Honey Heussler
- Mater Medical Research Institute, South Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
10
|
Anderson J, Marley C, Gillespie-Smith K, Carter L, MacMahon K. When the mask comes off: Mothers' experiences of parenting a daughter with autism spectrum condition. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1546-1556. [PMID: 32338537 DOI: 10.1177/1362361320913668] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
LAY ABSTRACT Parents of children with autism spectrum condition report increased stress and difficulties compared with parents of typically developing children. Our knowledge and understanding of how autism spectrum condition presents in autistic females is currently limited and parents of this population may experience challenges when raising their daughter. Given that mothers are often the main caregiver of a child with autism spectrum condition, they may have useful insights into the experiences of parenting a daughter with autism spectrum condition. Therefore, a qualitative study was undertaken to explore what mothers' experiences are of parenting a daughter with autism spectrum condition. Semi-structured interviews were conducted with 10 mothers of daughters with autism spectrum condition. The interviews were analysed using interpretative phenomenological analysis. Five main themes emerged from the qualitative study ('Girls have autism too', 'She's a chameleon', 'The impact of the diagnosis', 'Impact on mums' and 'Day-to-day life'). The findings of this study expand our current knowledge of the experiences and challenges faced by mothers raising a daughter with autism spectrum condition. Mothers hold a vast amount of knowledge on their daughters' autism spectrum condition which could inform the diagnostic process and clinical practice. Considering these results, it is important that clinicians support mothers and the family system around children with an autism spectrum condition diagnosis.
Collapse
|
11
|
Nicholas DB, MacCulloch R, Roberts W, Zwaigenbaum L, McKeever P. Tensions in Maternal Care for Children, Youth, and Adults With Autism Spectrum Disorder. Glob Qual Nurs Res 2020; 7:2333393620907588. [PMID: 32128352 PMCID: PMC7036502 DOI: 10.1177/2333393620907588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 11/22/2022] Open
Abstract
This study explored the experiences of mothers caring for an individual with
autism spectrum disorder (ASD) ranging from 5 to 25 years of age, and examined
pervasive tensions in caregiving. Guided by ethnographic methods, a
retrospective cross-sectional study was conducted. Interviews with 85 mothers
were analyzed inductively. Prevalent tensions in maternal caregiving were
identified: (a) difficulties obtaining, yet resistance to, an ASD diagnosis; (b)
identified giftedness of the child versus notions of deficit imposed by others;
(c) disability-related behaviors erroneously interpreted as ‘poor parenting’;
(d) contradictory considerations in diagnosis disclosure; (e) the invisibility
yet pervasiveness of ASD; (f) extensive need for, yet the lack of, accessible
services; (g) ASD-related care demands versus other pressing responsibilities;
(h) arguments for inclusive versus exclusive services; and (i) aims of nurturing
independence versus managing safety risk. Tensions were heightened by
insufficient supports relative to need. Implications and recommendations for
practice and policy are offered.
Collapse
Affiliation(s)
| | - Radha MacCulloch
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Wendy Roberts
- Intergrated Services for Autism and Neurodevelopmental Disorders, Toronto, Ontario, Canada
| | | | - Patricia McKeever
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
12
|
King G, Chiarello LA, Ideishi R, Ziviani J, Phoenix M, McLarnon MJW, Pinto M, Thompson L, Smart E. The complexities and synergies of engagement: an ethnographic study of engagement in outpatient pediatric rehabilitation sessions. Disabil Rehabil 2019; 43:2353-2365. [PMID: 31847621 DOI: 10.1080/09638288.2019.1700562] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate client (youth/caregiver) and service provider engagement in outpatient pediatric rehabilitation therapy sessions. METHODS In an ethnographic study, five research assistants attended 28 outpatient sessions, mostly delivered by occupational, physical, and speech-language therapists, and rated signs of client, provider, and relational engagement using the Pediatric Rehabilitation Intervention Measure of Engagement - Observation version. Post-session interviews were conducted individually with 13 youth, 15 caregivers, and 26 providers. RESULTS Overall, there was a moderate to great extent of engagement. Provider engagement was rated as higher than client engagement, particularly in sessions with activities focusing on body structure/function. The interviews indicated associations among engagement-related constructs: (a) expectations influenced engagement/disengagement and therapy progress, (b) engagement was associated with positive affect and relationships, and (c) engagement was strongly associated with relationships and collaboration. CONCLUSIONS Engagement is a central process within a complex system of psychosocial constructs operating in therapy. Engagement is emergent, synergistic, and change-inducing - it emanates from, involves, and influences multiple aspects of therapy. Notably, engagement ties two pivotal elements - positive expectations and positive affect - to positive relationships, collaboration, and therapy progress. Implications for practice include an understanding of how providers manage the therapeutic context and work to foster engagement.Implications for rehabilitationEngagement, and its various elements, plays a central role in shaping how clients, parents, and clinicians value therapeutic encounters.Optimal therapy is often thought to include engagement, relationships, and collaboration; the importance of therapy expectations, positive affect, and perceptions of progress are frequently overlooked.Engagement and motivation may be maximized when youth and caregivers are asked explicitly about how they view their engagement in therapy.In addition to clarifying and aligning expectations with youth and caregivers, service providers can enhance engagement and motivation by intentionally creating enjoyable and meaningful interactions, developing relationships, negotiating consensus on goals and plans, and demonstrating therapy progress.Service providers can harness engagement and the system of related constructs by listening and communicating effectively, by entering the world of the client and family, and by being aware of, anticipating, and responding to engagement and disengagement.
Collapse
Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Lisa A Chiarello
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Roger Ideishi
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle Phoenix
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,School of Rehabilitation Science and CanChild, McMaster University, Hamilton, Canada
| | | | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Laura Thompson
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Eric Smart
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
13
|
Vaz EMC, Collet N, Cursino EG, Forte FDS, Santos NCCDB, Reichert GP, da Nóbrega VM, Reichert APDS. Challenges in Primary Care Regarding Children and Adolescents With Chronic Conditions in Brazil. QUALITATIVE HEALTH RESEARCH 2019; 29:1978-1987. [PMID: 31088285 DOI: 10.1177/1049732319847961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The coordination of primary care is pivotal to the management of chronic conditions. However, current systems may not be as efficient or effective as one would hope. This article addresses to the managers and health teams in the primary care setting and their challenges regarding children and adolescents with chronic conditions in Brazil. A qualitative study was conducted with 26 primary care professionals and managers using thematic content analysis. The results showed a scarcity of specialists for referrals and a lack of professional training for dealing with this specific group of patients. It is necessary to improve health information systems to ensure the continuity of care. Current health care of children and adolescents with chronic conditions is neither efficient nor effective. For this type of care to be comprehensive, the health needs of this population must be addressed and the operational structure of the health care network must be strengthened.
Collapse
Affiliation(s)
| | - Neusa Collet
- Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | | | | | | | | | | |
Collapse
|
14
|
Petrou AM, Soul A, Koshy B, McConachie H, Parr JR. The impact on the family of the co-existing conditions of children with autism spectrum disorder. Autism Res 2018; 11:776-787. [DOI: 10.1002/aur.1932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 12/22/2017] [Accepted: 01/10/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Alexandra M. Petrou
- Institute of Neuroscience, Newcastle University; Newcastle Upon Tyne England
| | - Abigail Soul
- Institute of Neuroscience, Newcastle University; Newcastle Upon Tyne England
| | - Beena Koshy
- Institute of Neuroscience, Newcastle University; Newcastle Upon Tyne England
| | - Helen McConachie
- Institute of Health and Society, Newcastle University; Newcastle Upon Tyne England
| | - Jeremy R. Parr
- Institute of Neuroscience, Newcastle University; Newcastle Upon Tyne England
- Northumberland, Tyne and Wear NHS Foundation Trust
| |
Collapse
|
15
|
des Rivières-Pigeon C, Courcy I. « Il faut toujours être là. » Analyse du travail parental en contexte d’autisme. ENFANCES, FAMILLES, GÉNÉRATIONS 2017. [DOI: 10.7202/1045023ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cadre de la recherche : Avoir un enfant qui présente un trouble du spectre de l’autisme (TSA) est une situation complexe qui transforme de façon substantielle la réalité familiale. La charge de travail requise pour s’occuper de ces enfants constitue un aspect central de la vie de leurs familles qu’il convient de mieux documenter. Jusqu’à présent, les caractéristiques de ce « prendre soin » ont rarement été examinées dans la perspective des membres de la famille qui sont mobilisés.
Objectifs : Cet article présente une analyse approfondie du travail domestique et de soin réalisé par des parents d’enfant ayant un TSA et vivant au Québec.
Méthodologie : Un dispositif méthodologique original, alliant entretiens semi-dirigés et méthode participative de collecte de données, a été développé afin d’analyser le travail domestique et de soin réalisé par les parents. La recherche a été effectuée auprès de 15 familles (13 mères et 9 pères) présentant des profils variés.
Résultats : Les résultats mettent en lumière l’ampleur du travail effectué ainsi que l’expertise nécessaire à sa réalisation. Ils révèlent également le caractère à la fois spécialisé et spécifique de ce travail, et le rôle central du « travail en amont » visant à préparer et à organiser le travail réalisé auprès de l’enfant.
Conclusions : L’analyse en profondeur des tâches effectuées par les parents démontre qu’une grande proportion du travail réalisé, même s’il est complexe, touche des dimensions de base des responsabilités parentales, comme le fait de s’assurer que l’enfant soit propre, nourri et en sécurité.
Contribution :Cet article entend exposer l’expérience de parents d’enfant ayant un TSA, au-delà des représentations habituelles – lesquelles les montrent souvent comme des personnes vulnérables et démunies –, et ce, en révélant le travail complexe qu’ils réalisent pour répondre aux besoins spéciaux de leur enfant.
Collapse
Affiliation(s)
| | - Isabelle Courcy
- Ph. D., Professeure associée, département de sociologie, Université du Québec à Montréal,
| |
Collapse
|
16
|
McAuliffe T, Cordier R, Vaz S, Thomas Y, Falkmer T. Quality of Life, Coping Styles, Stress Levels, and Time Use in Mothers of Children with Autism Spectrum Disorders: Comparing Single Versus Coupled Households. J Autism Dev Disord 2017; 47:3189-3203. [DOI: 10.1007/s10803-017-3240-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|