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Li C, Cheung WC, Burke MM, Taylor JL, DaWalt LS. Examining the associations among knowledge, empowerment, and advocacy among parents of transition-aged youth with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2080-2089. [PMID: 38270137 PMCID: PMC11269520 DOI: 10.1177/13623613231221126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
LAY ABSTRACT Parents of individuals with autism face many challenges in finding appropriate services and support for their children, and they also play an important role in advocating for their children's rights and needs. Despite the increasing availability of advocacy programs, it is still uncertain how to best encourage parents to advocate for their children. This study explored the connection between parents' knowledge and sense of empowerment, and how these factors relate to three types of advocacy activities (i.e. individual, peer, and systemic). The findings reveal that feeling empowered has a greater impact on advocacy than simply having knowledge. In addition, the study found that individual advocacy correlates to more peer advocacy, which also correlates to more systemic advocacy. These results can help researchers and professionals to better develop programs to increase parent advocacy and, in turn, help improve the lives of individuals with autism.
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Rispoli KM, Curtiss SL, Naguib S. Brief transition-focused education for families of autistic youth: preliminary mixed-methods investigation. Disabil Rehabil 2024:1-9. [PMID: 38967010 DOI: 10.1080/09638288.2024.2365415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE The transition to adulthood is one of the most challenging and complex processes for autistic youth and their families. Few evidence-based transition support programs exist, and those that have garnered support require long-term commitments and resources that may prohibit participation by families with financial and time limitations. The current study investigated the feasibility and initial promise of a brief, caregiver-focused educational transition program for families of autistic youth delivered in the community over a single day. METHODS Quantitative informant-report and qualitative interview data were collected from 12 caregivers of autistic youth before and after program participation. Using a partially mixed sequential equal status design, quantitative and qualitative data were integrated to evaluate change in caregiver transition knowledge and empowerment, as well as caregivers' perceptions of program feasibility, acceptability, and usefulness. RESULTS Caregivers reported significant increases in knowledge of transition-related topics and sense of empowerment regarding their family life. Caregiver perceptions of the intervention suggest they found it feasible, acceptable, and useful. CONCLUSIONS Short-term transition programming may be a helpful option for caregivers who seek transition supports for autistic youth.
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Affiliation(s)
| | | | - Suzi Naguib
- Sunfield Center for Autism, ADHD and Behavioral Health, Ann Arbor, MI, USA
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Guerrero F, Zheng Q, Kramer J, Reichow B, Snyder P. A systematic review of the measurement properties of the Family Empowerment Scale. Disabil Rehabil 2024; 46:856-869. [PMID: 36843295 DOI: 10.1080/09638288.2023.2178528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE To systematically review and evaluate existing psychometric evidence for the Family Empowerment Scale (FES), which has been widely used to measure empowerment across the world. METHODS Three databases were searched up until December 2021. Eligible studies were identified by an interdisciplinary team using the PRISMA procedure. The methodological quality of psychometrics (Risk of Bias standards) and sufficiency of each psychometric property (e.g., reliability, content validity, construct validity, responsiveness) were independently evaluated by three members, following COnsesus-based Standards for the selection of health Measurement INstruments (COSMIN). RESULTS Twelve studies involving 3278 caregivers were included in the review. Studies reported limited information about content validity and study sample characteristics. There is sufficient evidence with moderate methodological quality to support structural validity for a four and three-bifactor structure. Sufficient evidence with good methodological quality was found for internal consistency. No studies examined responsiveness. CONCLUSIONS Future psychometric studies of the FES should include diverse families and establish content validity following current COSMIN standards. Structural validity evidence does not support the original three-factor structure, which suggests the need to refine the theoretical measurement constructs. Responsiveness is needed prior to using FES as an instrument of change in applied research studies.Implications for RehabilitationThe evidence for the use of the Family Empowerment Scale (FES) is primarily with families of children with disabilities who identify as white, non-Hispanic, and live in the US.Across studies, evidence suggests the FES items work well together to measure family empowerment.Caution should be used when using the FES to measure changes in empowerment over time.
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Affiliation(s)
- Fiorella Guerrero
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
| | - Qunshan Zheng
- Anita Zucker Center for Excellence in Early Childhood Studies, School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL, USA
| | - Jessica Kramer
- Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
| | - Brian Reichow
- Anita Zucker Center for Excellence in Early Childhood Studies, School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL, USA
- A.J. Pappanikou Center for Excellence in Developmental Disabilities, University of Connecticut Health Center, Farmington, CT, USA
| | - Patricia Snyder
- Anita Zucker Center for Excellence in Early Childhood Studies, School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL, USA
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Halki E, Kapiri M, Plakas S, Tsiou C, Govina O, Galanis P, Alikari V. Fatigue among Greek Parents of Children with Autistic Spectrum Disorder: The Roles of Spirituality and Social Support. Healthcare (Basel) 2024; 12:455. [PMID: 38391830 PMCID: PMC10887754 DOI: 10.3390/healthcare12040455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/20/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The high demands of caring for and raising a child with autism spectrum disorder on a daily basis may lead parents to physical and mental fatigue. This study aimed to assess the effect of social support and spirituality on the fatigue of parents with children with autistic spectrum disorder. A cross-sectional study with a convenience sample was conducted in Schools of Special Education in Attica (Greece). The sample consisted of 123 parents who completed The Fatigue Assessment Scale (FAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT Sp-12) to measure the levels of fatigue, social support, and spirituality, respectively. The Pearson correlation coefficient was used to investigate the relationship between the quantitative variables. To study the effect of social support and spirituality on fatigue, multivariable linear regression was applied. The mean age was 47.3 years old, 81.3% were women, and 38.9% stated "Close/Very close faith toward God". Higher levels of total MSPSS and FACIT Sp-12 were associated with lower total FAS (r = -0.50, p < 0.001 and r = -0.49, p < 0.001, respectively). Social support and spirituality were significant predictors of fatigue.
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Affiliation(s)
- Eugenia Halki
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Maria Kapiri
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Sotirios Plakas
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Chrysoula Tsiou
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Ourania Govina
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Petros Galanis
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Victoria Alikari
- Post Graduate Program "Management of Chronic Diseases- Neurosciences", Department of Nursing, University of West Attica, 12243 Athens, Greece
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Maughan AL, Lunsky Y, Lake J, Mills JS, Fung K, Steel L, Weiss JA. Parent, child, and family outcomes following Acceptance And Commitment Therapy for parents of autistic children: A randomized controlled trial. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:367-380. [PMID: 37165863 PMCID: PMC10851654 DOI: 10.1177/13623613231172241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
LAY ABSTRACT Parents of autistic children commonly experience difficulties with their own mental health. This study looked at the effects of a brief group-based Acceptance and Commitment Therapy program, developed for parents of autistic children, youth, and adults. ACT focuses on increasing psychological flexibility, which is the ability to be mindful and accepting of difficult thoughts and experiences, shown to be important for mental wellness. Participants included 54 parents of autistic people, ages 3-34. Parents were randomly divided into two groups: a Treatment group that received the intervention right away, and a Waitlist group that completed the program after the Treatment group completed the trial. All parents filled out questionnaires right before the program began, and at 3, 7, and 17 weeks after randomization. Compared to the group that was waiting to participate in the program, parents in the Treatment group reported greater improvements in depression and family distress, and these improvements were still present 4 months later. Parents in the Treatment group also reported short-term improvements in their positive feelings and personal goals, compared to those waiting. Results showed that ACT may help improve some aspects of mental health for parents of autistic children, but further research is recommended.
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Affiliation(s)
| | - Yona Lunsky
- Centre for Addiction and Mental Health, Canada
| | | | | | | | - Lee Steel
- Centre for Addiction and Mental Health, Canada
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Windarwati HD, Lestari R, Hidayah R, Hasan H, Ati NAL, Kusumawati MW, Selena IN, Dumar B, Rahayu G. Institutional and family support impact on health-related quality of life of children with autism spectrum disorders during the COVID-19 pandemic. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12450. [PMID: 38403996 DOI: 10.1111/jcap.12450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/01/2023] [Accepted: 12/31/2023] [Indexed: 02/27/2024]
Abstract
PROBLEMS Children with autism spectrum disorder (ASD) tend to have a notably poorer quality of life than the general population, especially during the COVID-19 pandemic. This study aimed to analyze the association between institutional support and family support on the health-related quality of life (HRQoL) of children with ASD during the COVID-19 pandemic. METHODS A cross-sectional study was conducted in October 2022 in a School for Special Needs in Malang City, East Java Province, Indonesia. The pediatric quality of life inventory (PedsQL) and Institutional and Family Support questionnaire were used to measure the HRQoL and support perceived by parents of children with ASD. We analyzed each component of the PedsQL and the Institutional and Family Support questionnaire. The independent T-test was performed to analyze the association between HRQoL and perceived support by parents of children with ASD. FINDINGS The results showed that most participants (72.7%) were women aged 40. As many as 69.39% of participants had more than one child, and 16.33% declared they had other children who experienced the same problem (special needs children). This study indicated that the average health-related quality of life score in children with ASD was 57.41 (9.418). The finding of this study showed a significant mean difference in HRQoL scores in children with ASD who received high institutional and family support compared to those who had low (p = 0.028, 95% confidence interval [CI] = -11.071 to 0.664). CONCLUSION Institutional support positively impacts children with ASD's quality of life. Therefore, it is essential to improve the adequacy of support felt by families while caring for children with ASD.
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Affiliation(s)
- Heni D Windarwati
- Department Mental Health Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
| | - Retno Lestari
- Department Mental Health Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
| | - Ridhoyanti Hidayah
- Department Mental Health Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
| | - Haliza Hasan
- Department of Special Care Nursing, International Islamic University Malaysia, Kulliyyah of Nursing, Kuantan, Malaysia
| | - Niken A L Ati
- Department of Community, Family & Geriatric Nursing, Faculty of Nursing, University of Jember, Jember, Indonesia
| | - Mira W Kusumawati
- Faculty of Health Sciences, University of Kusuma Husada, Surakarta, Indonesia
| | - Irhamna N Selena
- Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
| | - Bergita Dumar
- Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
| | - Gemi Rahayu
- Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
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Szlamka Z, Ahmed I, Genovesi E, Kinfe M, Hoekstra RA, Hanlon C. Conceptualising the empowerment of caregivers raising children with developmental disabilities in Ethiopia: a qualitative study. BMC Health Serv Res 2023; 23:1420. [PMID: 38102602 PMCID: PMC10722818 DOI: 10.1186/s12913-023-10428-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Caregivers of children with developmental disabilities (DDs) in Ethiopia experience stigma and exclusion. Due to limited existing services and substantial barriers to accessing care, they often lack support. Caregiver empowerment could help address injustices that hinder their capacity to support their child as they would like. The aim of this study was to explore the meaning and potential role of empowerment for caregivers raising a child with a DD and how empowerment was situated in relation to other priorities in service development. METHODS This was a qualitative phenomenological study. Semi-structured interviews were conducted in Amharic and English with caregivers of children with a DD (n = 15), clinicians (n = 11), community-based health extension workers (n = 5), representatives of non-governmental organisations working with families with DDs (n = 17), and representatives of local authorities in health, education, and social care (n = 15). Data were analysed thematically. RESULTS Three main themes were developed: "Barriers to exercising caregivers' agency"; "Whose decision is it to initiate empowerment?"; and "Supporting caregivers through support groups". Caregiver capacity to do what they thought was best for their child was undermined by poverty, a sense of hopelessness, experience of domestic abuse and multiple burdens experienced by those who were single mothers. Caregivers were nonetheless active in seeking to bring about change for their children. Caregivers and professionals considered support groups to be instrumental in facilitating empowerment. Participants reflected that caregiver-focused interventions could contribute to increasing caregivers' capacity to exercise their agency. A tension existed between a focus on individualistic notions of empowerment from some professionals compared to a focus on recognising expertise by experience identified as vital by caregivers. Power dynamics in the context of external funding of empowerment programmes could paradoxically disempower. CONCLUSION Caregivers of children with DDs in Ethiopia are disempowered through poverty, stigma, and poor access to information and resources. Shifting power to caregivers and increasing their access to opportunities should be done on their own terms and in response to their prioritised needs.
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Affiliation(s)
- Zsofia Szlamka
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Ikram Ahmed
- Department of Psychiatry, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity-Building, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Elisa Genovesi
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mersha Kinfe
- Department of Psychiatry, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity-Building, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rosa A Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Charlotte Hanlon
- Department of Health Service and Population Research, Institute of Psychiatry, Centre for Global Mental Health, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, School of Medicine, WHO Collaborating Centre for Mental Health Research and Capacity-Building, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa, Addis Ababa University, Addis Ababa, Ethiopia
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Chua SY, Abd Rahman FN, Ratnasingam S. Problem behaviours and caregiver burden among children with Autism Spectrum Disorder in Kuching, Sarawak. Front Psychiatry 2023; 14:1244164. [PMID: 37965356 PMCID: PMC10642943 DOI: 10.3389/fpsyt.2023.1244164] [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: 06/22/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Objective Caregivers of children with Autism Spectrum Disorder (ASD) often experience emotional and psychological distress, as well as disruptions to family life and employment due to the challenges of caring for children with ASD. This study examines the relationship between problem behaviours and caregiver burden among children with ASD. Method A cross-sectional study using convenience sampling recruited 230 caregivers of children with ASD aged 4 to 18 years from selected autism centres in Kuching, Sarawak. The caregivers completed the Aberrant Behaviour Checklist-2 and the Zarit Burden Interview. Results Univariate analysis revealed a significant difference in caregiver burden for children with ASD receiving medications (p = 0.013), registered with the Social Welfare Department (p = 0.036), and having siblings with ASD (p = 0.046). About 40% of the children exhibited at least one domain of problem behaviour. More than half of the caregivers (53.9%) experienced burden, with the majority experiencing mild burden. Positive associations were seen between irritability (r = 0.458, p < 0.01), social withdrawal (r = 0.439, p < 0.01), stereotypic behaviour (r = 0.392, p < 0.01), hyperactivity/non-compliance (r = 0.467, p < 0.01), and caregiver burden. Child factors, including the duration of problem behaviour (r = 0.182, p = 0.007), medication use (eta = 0.187, p = 0.005), Social Welfare Department registration (eta = 0.138, p = 0.036), and the presence of siblings with ASD (eta = 0.130, p = 0.046) were associated with caregiver burden. Multiple linear regression showed that hyperactivity/noncompliance significantly predicted caregiver burden. Conclusion Specific problem behaviours in children with ASD were associated with caregiver burden. These results highlight the need for interventions for the child with ASD and their caregivers.
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Affiliation(s)
- Shi Yi Chua
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Child and Adolescent Psychiatric Unit, UKM Specialist Children’s Hospital, Kuala Lumpur, Malaysia
| | - Selvasingam Ratnasingam
- Department of Psychiatry and Mental Health, Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
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Bogavac I, Jeličić L, Đorđević J, Veselinović I, Marisavljević M, Subotić M. Comparing Anxiety Levels during the COVID-19 Pandemic among Mothers of Children with and without Neurodevelopmental Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1292. [PMID: 37628291 PMCID: PMC10453906 DOI: 10.3390/children10081292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
The COVID-19 pandemic undoubtedly burdened families, perhaps even more for parents of children with neurodevelopmental disabilities. This research aims to determine the anxiety levels in mothers of children with neurodevelopmental disorders (autism spectrum disorder and specific language impairment) and mothers of typically developed children. The cross-sectional study comprised 280 mothers from the period of the COVID-19 pandemic in Serbia. A confidential survey included main demographic data and the State-Trait Anxiety Inventory (STAI). Results revealed that the mean levels of STAI-S and STAI-T are elevated in the observed sample of mothers in the first pandemic wave; the STAI-S level is in the high category (STAI-S mean = 46.69), while STAI-T is in the intermediate category near the cut-off value for the high level (STAI-T mean = 43.04). A statistically significant strong positive correlation between STAI-S and STAI-T is seen (r = 0.802, p = 0.001). GLMM analysis revealed that interactions, rather than independent variables, significantly impact anxiety, implying a complex relationship between the observed variables and STAI. Compared with the results from the pre-pandemic study, our findings reveal that COVID-19 affects mothers of children with and without neurodevelopmental disorders in a complex manner, imposing a need for psychological support, which may positively affect mothers' mental health and the development of their offspring.
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Affiliation(s)
- Ivana Bogavac
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (I.B.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetic and Speech Pathology, 11000 Belgrade, Serbia
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (I.B.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetic and Speech Pathology, 11000 Belgrade, Serbia
| | - Jelena Đorđević
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- Clinic for Neurology and Psychiatry for Children and Adolescents, 11000 Belgrade, Serbia
| | - Ivana Veselinović
- Department of Defectology-Hearing Disability, Faculty of Special Education and Rehabilitation, University of Belgrade, 11000 Belgrade, Serbia;
| | - Maša Marisavljević
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (I.B.); (M.M.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetic and Speech Pathology, 11000 Belgrade, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Institute”, 11000 Belgrade, Serbia; (I.B.); (M.M.); (M.S.)
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Stankova M, Kamenski T, Ivanov I, Mihova P. Emotional and Behavioral Problems of Children with ASD-The Lessons That We Learned from the Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:969. [PMID: 37371201 PMCID: PMC10297218 DOI: 10.3390/children10060969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
The data available for changes in the behavior and emotional state of children with ASD (autism spectrum disorder) in lockdown situations are controversial and scarce. In our research, we compare results before the first COVID-19 lockdown of 21 children with ASD and 21 typically developing children, four to five years of age with those obtained immediately after. The study attempts to answer the question of whether there are changes in the levels of emotional and behavioral problems in children with ASD after the lockdown and how these new living conditions affect some aspects of their functioning. The instruments used for data analysis are the Childhood Autism Spectrum Test (CAST); Child Behavior Checklist (CBCL); Survey on the consequences of COVID-19 on the life and development of the participants. No significant differences in the emotional and behavioral state of the participants were found, except for attention deficit/hyperactivity problems where ASD children showed lower levels after the lockdown. ASD group parents' answers to the survey pointed towards more positive consequences of staying at home. Some reported they had more time for learning together, communicating, playing, and assisting the learning process through online therapy. As negatives, the parents of ASD children reported low physical activity, increased time with electronic devices, and time spent with the same people. Caregivers of typically developing children agreed that the lockdown had only negative effects. To conclude, for children with ASD in the study, the lockdown period demonstrated that more time spent with parents in structured everyday activities is an opportunity that can lead to positive results in their behavior.
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Affiliation(s)
- Margarita Stankova
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
| | - Tsveta Kamenski
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
| | - Ivan Ivanov
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA;
| | - Polina Mihova
- Department of Health Care and Social Work, New Bulgarian University, 1618 Sofia, Bulgaria; (T.K.); (P.M.)
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Dimachkie Nunnally A, Factor RS, Sturm A, Valluripalli Soorya L, Wainer A, Taylor S, Ponzini M, Abbeduto L, Gulsrud AC. Examining indicators of psychosocial risk and resilience in parents of autistic children. Front Behav Neurosci 2023; 17:1102516. [PMID: 37255619 PMCID: PMC10226532 DOI: 10.3389/fnbeh.2023.1102516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Background Parents of autistic children experience increased levels of caregiver strain and adverse mental health outcomes, even in comparison to parents of children with other neurodevelopmental disabilities. Previous studies have largely attributed these increased levels of mental health concerns to their child behavioral concerns and autism symptomatology, but less attention has been given to other potential child factors, such as child adaptive functioning. Additionally, little is known about potential protective factors, such as parents' emotion regulation (ER) abilities, that may ameliorate the experience of caregiver strain, anxiety, and depression. Objective The current study examined the impact of child characteristics (restricted and repetitive behaviors, adaptive functioning and behavioral concerns) on parent mental health outcomes (caregiver strain, anxiety, depression and wellbeing). Additionally, we explore parents' ER abilities as a moderator of the impact of child characteristic on parents' mental health outcomes. Results Results of linear mixed effect models indicated a significant relationship between parents' ER abilities and all four parent outcomes. Additionally, children's adaptive functioning abilities and repetitive behaviors (RRBs) were significant predictors of caregiving strain. Parents' ER abilities were a significant moderator of the effect of children's repetitive behaviors and adaptive functioning challenges on caregiver strain, such that better ER abilities mitigated the impact of child clinical factors on caregiver strain. Finally, a significant difference was detected for mothers' and fathers' mental health, with mothers reporting higher caregiver strain, and more symptoms of anxiety and depression than did fathers. Conclusion This study leveraged a large sample of autistic children and their biological parents to examine the relationship between children's clinical characteristics and parents' psychological wellbeing. Results indicate that, although parents of autistic children do experience high rates of internalizing mental health concerns that relate to child adaptive functioning and RRBs, parent ER abilities act as a protective factor against parents' adverse mental health outcomes. Further, mothers in our sample reported significantly higher rates of depression, anxiety, and caregiver strain, as compared with fathers.
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Affiliation(s)
- Amanda Dimachkie Nunnally
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Reina S. Factor
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alexandra Sturm
- Department of Psychological Science, Loyola Marymount University, Los Angeles, CA, United States
| | - Latha Valluripalli Soorya
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Allison Wainer
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Sandra Taylor
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Matthew Ponzini
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Amanda C. Gulsrud
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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Wilmot A, Pizzey H, Leitão S, Hasking P, Boyes M. "I struggle at times to see her struggle": Mothers' perspectives on dyslexia-related school struggles and the inter-connected nature of mother and child well-being. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:136-150. [PMID: 36755469 PMCID: PMC10946717 DOI: 10.1002/dys.1733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Parents of children with dyslexia may be at elevated risk for parenting stress and mental health concerns. Our aim was to explore the emotional experience of growing up with dyslexia in Australia from parents' perspectives. In so doing, we also developed an understanding of parents' own mental health and support needs informed by their lived experience. METHODOLOGY Seventeen interviews with mothers of children (9-14 years; 16 with a diagnosis of dyslexia) were analysed using Braun and Clarke's reflexive thematic analysis approach. ANALYSIS Five themes were developed to address our aim: Theme 1: Years in the wilderness: Life before diagnosis; 2: "I struggle at times to see her struggle"; 3. School struggles: Advocating for our children and managing distress; 4. "It's a full-time job" and a "long slog"; 5: Care for the carer: Social support and coping strategies. CONCLUSIONS Our analysis suggests that mothers of children with dyslexia may be at elevated risk for mental health concerns. Specifically, chronic worry and stress, secondary distress, challenges to parenting self-efficacy, and lack of support and understanding (feeling isolated) were highlighted as plausible risk factors. Mothers described coping strategies at the community level (e.g., school connectedness) and at the individual level (e.g., "acceptance") as protective.
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Affiliation(s)
- Adrienne Wilmot
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Hannah Pizzey
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Suze Leitão
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Allied HealthBentleyAustralia
| | - Penelope Hasking
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
| | - Mark Boyes
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
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13
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Tan WY, Hamzaid NH, Ibrahim N. Parental Perceptions on the Importance of Nutrients for Children with Autism Spectrum Disorder (ASD) and the Coping Strategies: A Qualitative Study. Nutrients 2023; 15:nu15071608. [PMID: 37049449 PMCID: PMC10096955 DOI: 10.3390/nu15071608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a developmental disorder that comes with co-occurring eating behavior such as limited food varieties, selective food intake, and repetitive eating patterns, contributing to significant challenges for their parents. Many parents find mealtimes difficult and develop anxiety or stress about their child’s nutrition, health, and overall well-being. Hence, parents must equip themselves with the correct awareness and nutrition knowledge. An online open-ended semi-structured interview was conducted among fifteen parents from the community-rehabilitation program center to explore their understanding of nutrition’s importance and the possible coping strategies when facing challenges. The interview sessions were recorded, followed by three researchers’ coding processes. Data were then subjected to thematic analysis. The interview sessions suggested that the parents were aware of the autism trait eating behavior and had a general knowledge about nutrition. However, it was quite challenging when it came to preparation. Nevertheless, the parents are able to manage the challenges with unique kinds of coping strategies. In addition, a complete educational dietary intervention program including psychosocial aspects for parents is recommended for better effectiveness.
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14
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Lobato D, Montesinos F, Polín E, Cáliz S. Third-Generation Behavioural Therapies in the Context of Neurodevelopmental Problems and Intellectual Disabilities: A Randomised Clinical Trial with Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4406. [PMID: 36901415 PMCID: PMC10002330 DOI: 10.3390/ijerph20054406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to examine how 14 parents of children with autism and intellectual impairments responded to an Acceptance and Commitment Therapy (ACT)-based psychological flexibility intervention programme. A randomised clinical trial was conducted. Parents were randomly assigned to the training programme group (n = 8) or waiting list group (n = 6). The treatment effect was measured using the 6-PAQ, PSS-14, GHQ-12, and WBSI questionnaires. Changes in interactions were assessed through self-recording, including a baseline to observe the previous functioning. Measures were taken before and after the application of the intervention programme and three months later. After that, the control group was switched to the psychological flexibility programme condition. After the programme's implementation, we could see a reduction in stress and the tendency to suppress unwanted private events. The impacts also appeared to apply to family interactions, resulting in a rise in positive interactions and a decrease in unfavourable ones. The results led us to think about the importance of psychological flexibility for the parents of children with chronic conditions, facilitating a reduction in the emotional impact derived from parenting and the emission of behaviours that promote the harmonious development of the diagnosed child.
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Affiliation(s)
- David Lobato
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Francisco Montesinos
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
- Instituto ACT, 28036 Madrid, Spain
| | - Eduardo Polín
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Saray Cáliz
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
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15
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Wright SR, Graham CD, Houghton R, Ghiglieri C, Berry E. Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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McCrossin J, Lach L, McGrath P. Content analysis of parent training programs for children with neurodisabilities and mental health or behavioral problems: a scoping review. Disabil Rehabil 2023; 45:154-169. [PMID: 34990567 DOI: 10.1080/09638288.2021.2017493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Several systematic reviews have examined parent training programs for families of children with autism spectrum disorder (ASD). The present review expands on this literature by describing the components, delivery methods, and level of parent involvement in parent training programs that target families of children with any neurodisability and comorbid disruptive behavior or other mental health problem. MATERIALS AND METHODS Following a scoping review protocol, the search strategy included randomized controlled trials of parent training programs conducted with families of children with neurodisabilities and comorbid disruptive behavior or mental health problems. Study characteristics, program content, delivery methods, and theoretical frameworks were extracted from eligible studies. RESULTS A total of 22 articles were included from the 453 full-text articles initially screened. Thirteen different programs fell into two general categories based on whether they targeted child disruptive behavior or anxiety. Analysis of the content yielded five themes: child skill enhancement, parenting as enacted, parenting as experienced, disability-related parenting, and parent-child relationships. The theoretical underpinnings were identified, when possible, from each study. CONCLUSIONS Parent training programs for parents of children with neurodisabilities targeting child anxiety involved parents in a complementary role in treatment while those targeting disruptive behavior involved parents in a primary role in creating behavior change. We suggest that the extent of parent involvement in interventions be guided by theory rather than diagnosis of the child.Implications for rehabilitationParents of children living with neurodisabilities play a key role in delivering interventions to address comorbid mental health or behavioral problems.Parent training programs for families of children with neurodisabilities vary in relation to their aims, involvement of parents in delivering interventions, disability-specific content, and delivery methods.When referring families, rehabilitation professionals should be aware of aspects of child, parent, and family relational well-being targeted by parent training programs and, when feasible, give families a choice of the style of program to meet their needs.
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Affiliation(s)
| | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Canada
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17
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Chien YL, Wu CS, Chang YC, Cheong ML, Yao TC, Tsai HJ. Associations between parental psychiatric disorders and autism spectrum disorder in the offspring. Autism Res 2022; 15:2409-2419. [PMID: 36250255 DOI: 10.1002/aur.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022]
Abstract
Whether parental psychiatric disorders are associated with autism spectrum disorder (ASD) in offspring has remained inconclusive. We examined the associations of parental psychiatric disorders with ASD in offspring. This population-based case-control study used Taiwan's National Health Insurance Research Database to identify a cohort of children born from 2004 to 2017 and their parents. A total of 24,279 children with ASD (diagnostic ICD-9-CM code: 299.x or ICD-10 code F84.x) and 97,715 matched controls were included. Parental psychiatric disorders, including depressive disorders, bipolar spectrum disorders, anxiety disorders, obsessive-compulsive disorder, schizophrenia, substance use disorders, autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), and adjustment disorders were identified. Conditional logistic regressions with covariate adjustment were performed. The results suggest that parental diagnosis with any of the psychiatric disorders is associated with ASD in offspring (adjusted odds ratio [AOR] = 1.45, 95%CI: 1.40-1.51 for mothers; and AOR = 1.12, 95%CI: 1.08-1.17 for fathers). ASD in offspring was associated with schizophrenia, depressive disorders, obsessive-compulsive disorder, adjustment disorders, ADHD and ASD in both parents. The relationship between parental psychiatric disorders and the timing of the child's birth and ASD diagnosis varied across the different psychiatric disorders. The present study provides supportive evidence that parental psychiatric disorders are associated with autistic children. Furthermore, because the associations between parental psychiatric disorders and the timing of child's birth and ASD diagnosis varied across psychiatric disorders, the observed relationships may be affected by both genetic and environmental factors. Future studies are needed to disentangle the potential influence of genetic and environmental factors on the observed associations.
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Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Douliu, Taiwan
| | - Yen-Chen Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Mei-Leng Cheong
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,College of Life Science, National Tsing-Hua University, Hsinchu, Taiwan
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18
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Ferenc K, Płatos M, Byrka K, Król ME. Looking through rainbow-rimmed glasses: Taking neurodiversity perspective is related to subjective well-being of autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221135818. [DOI: 10.1177/13623613221135818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Finding new ways of supporting the well-being of autistic adults is an essential goal for research and practice. We tested the predictive value of attitudes towards autism (as neurodiversity or as a disorder) and identification with other autistic people, on the psychological distress and self-esteem of autistic adults ( n = 109). Adopting a neurodiversity attitude not only predicted higher self-esteem but also served as a protective factor against the negative impact of identification with other autistic people on psychological distress. These findings show that clinicians should be sensitive to the way autistic people understand autism and the extent to which they identify with the autism community, as these factors relate to their well-being. Lay abstract Autistic adults experience a high level of distress. Finding new ways to support their well-being is an important goal for researchers and clinicians. We assessed the way autistic adults view their autism, as a disorder or as a type of mind (neurodiversity), and the level they integrate with other autistic people, and we checked how those factors contribute to their well-being. People who see autism rather as a type of mind than as a disorder had higher self-esteem. People who view themselves as more similar to other autistic people felt more stressed, but this result was not accurate for people who view autism as a type of mind. Clinicians should be sensitive to the way autistic people understand autism and to what extent they identify with the autism community, because it may relate to their well-being.
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Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
| | - Mateusz Płatos
- University of Warsaw, Poland
- Association for Social Innovation ‘Mary and Max’, Poland
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19
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Szlamka Z, Hanlon C, Tekola B, Pacione L, Salomone E, Servili C, Hoekstra RA. Exploring contextual adaptations in caregiver interventions for families raising children with developmental disabilities. PLoS One 2022; 17:e0272077. [PMID: 36170237 PMCID: PMC9518887 DOI: 10.1371/journal.pone.0272077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
There are increasing efforts to scale up services globally for families raising children with developmental disabilities (DDs). Existing interventions, often developed in high income, Western settings, need substantial adaptation before they can be implemented in different contexts. The aim of this study was to explore perspectives on the role that context plays in the adaptation and implementation of interventions targeting caregivers of children with DDs across settings. The study question was applied to the Caregiver Skills Training (CST) programme of the World Health Organization specifically, as well as to stakeholder experiences with caregiver interventions more broadly. Two focus group discussions (FGDs; n = 15 participants) and 25 individual semi-structured interviews were conducted. Participants were caregivers of children with DDs and professionals involved in adapting or implementing the CST across five continents and different income settings. Data were analysed thematically. Four main themes were developed: 1) Setting the scene for adaptations; 2) Integrating an intervention into local public services; 3) Understanding the reality of caregivers; 4) Challenges of sustaining an intervention. Informants thought that contextual adaptations were key for the intervention to fit in locally, even more so than cultural factors. The socio-economic context of caregivers, including poverty, was highlighted as heavily affecting service access and engagement with the intervention. Competing health priorities other than DDs, financial constraints, and management of long-term collaborations were identified as barriers. This study validates the notion that attention to contextual factors is an essential part of the adaptation of caregiver interventions for children with DDs, by providing perspectives from different geographical regions. We recommend a stronger policy and research focus on contextual adaptations of interventions and addressing unmet socio-economic needs of caregivers.
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Affiliation(s)
- Zsofia Szlamka
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Charlotte Hanlon
- Centre for Global Mental Health, Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bethlehem Tekola
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Laura Pacione
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
- Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Erica Salomone
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - WHO CST Team
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Rosa A. Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
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Leung CNW, Tsang B, Huang DH, Chan RWS. Building Self-Efficacy in Parenting Adult Children With Autistic Spectrum Disorder: An Initial Investigation of a Two-Pronged Approach in Role Competence. Front Psychol 2022; 13:841264. [PMID: 35941955 PMCID: PMC9355802 DOI: 10.3389/fpsyg.2022.841264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/01/2022] [Indexed: 12/05/2022] Open
Abstract
Previous studies on parenting adult children with ASD were scarce, and their intervention protocols mainly were derived from established work with children. Development of an applicable adult-oriented protocol and demonstration of its effectiveness is warranted. The present study outlined the development and evaluation of Core Autism Parenting Skills (CAPS), which targets to enhance parenting self-efficacy (PSE) intervention for adult children with ASD by addressing two intervention goals in parallel: acquisition of parenting skills and cultivating positive attributes. In CAPS, PSE is operationalised into four parent roles: to observe, reinforce, empathise, and accompany, each with requisite attributes, skills, and prescribed training. Twenty-seven parents with adult children with ASD (aged 16-37) were recruited. They completed measures assessing their PSE, competence in the four parent roles, and emotional well-being at pre-training, post-training and 2-month follow-up. The intervention was well-received by the participants and reported significant improvements in PSE, parent role competence at post-training and 2-month follow-up. The applicability of PSE and parent role competence in constructing effective parenting intervention for adult children with ASD was supported.
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21
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Muharib R, Dowdy A, Rajaraman A, Jessel J. Contingency-based delay to reinforcement following functional communication training for autistic individuals: A multilevel meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:761-781. [PMID: 34961394 DOI: 10.1177/13623613211065540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Functional communication training, an intervention for challenging behavior rooted in principles of applied behavior analysis, has copious empirical support dating back to the mid-1980s for autistic individuals. Recently, there has been a concerted effort to thin reinforcement delivery during functional communication training using contingency-based delays that, in turn, are designed to enhance practicality and feasibility while not compromising efficacy. In this synthesis, we meta-analyzed the literature base with the goal of investigating both combined and across type effectiveness of contingency-based delays. We also aimed to investigate moderating variables that might impact intervention outcomes. Findings showed that contingency-based delays were effective for individuals with an autism spectrum disorder diagnosis and most effective when the delay incorporated some form of positive reinforcement. In addition, differential reinforcement of alternative-based delays was overall more effective when compared to differential reinforcement of other behavior-based delays. Noteworthy moderating variables found to impact contingency-based delay efficacy included the intervention dosage and the topography of behavior. We discuss these findings and highlight directions where additional empirical research is warranted to improve our understanding about contingency-based delays for individuals diagnosed with autism spectrum disorder.
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22
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Ronis SD, Lee E, Cuffman C, Burkhart K. Impact of Social and Relational Adversity on Access to Services among US Children with Autism Spectrum Disorder 2016–2019. CHILDREN 2021; 8:children8121099. [PMID: 34943296 PMCID: PMC8700475 DOI: 10.3390/children8121099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
To explore the impact of social and relational adversity on access to key health services among US children with autism spectrum disorders (ASD), cross-sectional analyses of the 2016–2019 National Survey of Children’s Health assessed use of key health services by children with ASD, accounting for differences in demographic characteristics, medical needs, and experience of social and relational adversities. sUS children with ASD were more than twice as likely as peers without ASD to report two or more social adversities and more than three times as likely to report two or more relational adversities. In multivariable models, relational adversities were significantly associated with greater odds of medication use for ASD (OR 1.50, 95%CI:1.02, 2.17). Social adversities were neither associated with receipt of behavioral therapies nor prescription of medication to treat ASD. Screening for various forms of adversity among youth with ASD is of great importance; even one adverse experience may be enough to influence care of a child with ASD, with differences in effect according to the nature of the particular adversity. Further research should evaluate the role that childhood adversity plays in physical and mental health outcomes in ASD.
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Affiliation(s)
- Sarah D. Ronis
- Center for Child Health and Policy, UH Rainbow Babies and Children’s Hospital, 11100 Euclid Avenue, MS 6036, Cleveland, OH 44106, USA
- Department of Pediatrics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; (E.L.); (K.B.)
- Correspondence: ; Tel.: +1-216-286-6933
| | - Eunice Lee
- Department of Pediatrics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; (E.L.); (K.B.)
| | - Carrie Cuffman
- Center for Developmental Pediatrics, Cleveland Clinic Children’s, 2801 Martin Luther King Drive, Cleveland, OH 44104, USA;
| | - Kimberly Burkhart
- Department of Pediatrics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; (E.L.); (K.B.)
- Division of Developmental and Behavioral Pediatrics and Psychology, UH Rainbow Babies and Children’s Hospital, W.O. Walker Building, 10524 Euclid Avenue Suite 3150, Cleveland, OH 44106, USA
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23
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Long MA, Stretesky PB, Crilley E, Sattar Z, Defeyter MA. Examining the relationship between child holiday club attendance and parental mental wellbeing. PUBLIC HEALTH IN PRACTICE 2021; 2:100122. [PMID: 36101602 PMCID: PMC9461366 DOI: 10.1016/j.puhip.2021.100122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
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Roy RG, Kumar A. The mediating role of parental playfulness on parent–child relationship and competence among parents of children with ASD. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-02-2021-0010] [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]
Abstract
Purpose
The difficulties of a child diagnosed with autism spectrum disorder (ASD) can lead to behaviours that are quite challenging for parents to understand and address. Most of the parental studies of ASD focus on the challenges faced by the parents. This study aims to adopt a strength-based model that investigates the mediating role of parental playfulness in the association between parent–child relationship and parental competence.
Design/methodology/approach
This study is a quantitative study that adopts a correlational research design. The mediation analysis explores the role of parental playfulness as a mediator in the association between parent–child relationship and parental competence. The sample consisted of 120 parents of children diagnosed with ASD from India, selected using a purposive sampling technique.
Findings
The mediation analysis results indicate that playfulness among parents of children with ASD was found to function as a partial mediator in the relationship between parent–child relationship and parental competence. This could suggest that more playful parents have better parent–child relationships and are competent in parenting.
Research limitations/implications
These findings have importance in understanding the role of playful interaction on parent–child relationships and parenting competence, having implications for further research. Enabling playfulness in parenting will enhance children and parents to promote their relationship and thus feel competent to bring positive light in their lives.
Practical implications
Most often, the clinicians are concerned with addressing only the autistic symptoms; it is also essential to look into parental well-being. Practical playful interaction training should help parents establish a rapport, understand, adjust and adapt with their child.
Social implications
Practical intervention and training plans can be suggested to all family members to improve the condition of the child and the family’s general well-being. As the study focused on the clinical population, the findings could provide useful inputs for mental health professionals and counsellors.
Originality/value
There are some theoretical and empirical evidence that support positive outcomes of playfulness on personal well-being (Atzaba Poria, in press; Yue et al., 2016; Proyer, 2014). Although there has been some interest in the impact of children’s playfulness on their development (Bundy, 1997), little is known about the influence of parental playfulness on parents and children. Therefore, addressing these gaps, this empirical study focusses on investigating the role of parental playfulness in parent–child relationship and parental competence, rather than considering external challenges of parents based on the ASD child’s behavioural challenges and autistic features.
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25
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Al-Oran HM, Khuan L. Predictors of parenting stress in parents of children diagnosed with autism spectrum disorder: a scoping review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00345-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Identifying the predictors of parenting stress in parents of children with autism spectrum disorder is crucial to provide the best health-care services.
Main text
The scoping review was conducted. Search engines (EBSCO, Springer, PubMed, Ovid, Google Scholar, and Science Direct) were used to collate published studies between the years 2009 and 2020. Keywords used were parenting stress, parental stress, predictors of parenting stress, Autism disorder, Autism, and scoping review. Primary screening of the titles and abstracts of 1039 articles was conducted. The secondary screening of 348 articles resulted in 27 articles included in this review. The reviewed articles revealed core symptoms of the disorder, namely, behavior problems, and socio-communication impairments strongly linked with the high level of parenting stress.
Conclusion
This scoping review is the initial step toward encouraging future efforts to provide supportive interventions for parents of children with autism spectrum disorder.
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Jose P, Sundaram S, Varma RP. Buffering Effect of Spousal Support on Stress Levels in Mothers of Children with a Diagnosis of Autism Spectrum Disorder in Kerala, India. J Neurosci Rural Pract 2021; 12:535-542. [PMID: 34295109 PMCID: PMC8289558 DOI: 10.1055/s-0041-1727559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives
Bringing up a child with the diagnosis of autism spectrum disorder (ASD) can be highly stressful. This study aimed to assess perceived stress, level of spousal support, emotion-focused coping styles, and other potentially associated factors among mothers accompanying children diagnosed with ASD for care from selected institutions in Kerala, India.
Materials and Methods
Consenting parents accompanying children to therapeutic programs in selected institutions were administered a semi structured interview schedule incorporating questions of the vernacular version of the Perceived Stress Scale (PSS-10), emotion-based coping strategies, spousal support in care of the child diagnosed with ASD, and possible-associated factors. Since internal consistency of stress and coping questionnaires were low, principal component analysis was used to extract composite variables with reasonable psychometric characteristics for stress and coping.
Statistical Analysis
Ordinal logistic regression was performed with a three-level stress category as the outcome variable.
Results
High stress was significantly associated with low spousal support (adjusted odds ratio or AOR: 2.80; 95% confidence intervals or CI 1.28–6.11), having a completely dependent child (AOR 4.24 [95% CI 1.92–9.38]), and low acceptance levels (AOR 2.60 [95% CI 1.14–5.89]). Unlike mothers with high spousal support, mothers with low spousal support were likely to have difficulty in interacting with others (
p
= 0.02) and a low level of acceptance (
p
= 0.05).
Conclusion
Spousal support is important to preserve psychological health in mothers of children diagnosed with ASD. Mothers with low spousal support may need interventions that help increase acceptance levels or decrease avoidant behavior.
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Affiliation(s)
- Prinu Jose
- Achutha Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Soumya Sundaram
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.,Comprehensive Care Centre for Neurodevelopmental Disorders (CCCND), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ravi Prasad Varma
- Achutha Menon Center for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.,Comprehensive Care Centre for Neurodevelopmental Disorders (CCCND), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Kidd KM, Hill A, Sequeira GM, McMillan C, Switzer G, Rofey D, Miller E, Montano GT. Development and Psychometric Analysis of the Transgender Family Acceptance To Empowerment (TransFATE) Scale. J Adolesc Health 2021; 68:1096-1103. [PMID: 33268218 PMCID: PMC8053728 DOI: 10.1016/j.jadohealth.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Parent and caregiver support can reduce health disparities experienced by gender diverse youth (GDY). Parent and caregiver empowerment improves health outcomes for children with medical and mental health diagnoses, but no existing scale measures this construct in families of GDY. We aimed to develop a scale measuring empowerment in parents and caregivers of GDY. METHODS We adapted two existing scales and added investigator-derived items to create a survey instrument. We revised using input from focus groups and experts assessing face and content validity. Using the revised scale, we surveyed parents and caregivers of GDY from across the U.S. to assess the construct validity through exploratory and confirmatory factor analyses, internal consistency, and convergent validity. RESULTS The initial 67 items were reduced to 42 items after face and content validity analyses. Parents and caregivers (n = 309) from 31 states completed the revised measure. Most participants were white (81.4%), mothers (69.3%), and parenting a gender diverse child who identifies on the binary (transmasculine, male, transfeminine, or female; 91.3%). Exploratory factor analyses showed a two-factor solution: Factor 1 having 10 items (Cronbach's alpha = .86) and Factor 2 having six items (Cronbach's alpha = .86). Our confirmatory factor analysis demonstrated good fit (Comparative Factor Index = .972, Tucker-Lewis Index = .968, Root Mean Square Error of Approximation = .060 [90% confidence interval = .410-.078], and Standardized Root Mean Square Residual = .062). CONCLUSIONS The Transgender Family Acceptance To Empowerment (TransFATE) scale demonstrates face, content, and construct validity among a geographically diverse sample of GDY's parents and caregivers. This scale has the potential to aid in developing and evaluating programs focused on building stronger social supports for GDY through increased family empowerment.
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Affiliation(s)
- Kacie M Kidd
- Center for Adolescent & Young Adult Health, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Amber Hill
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gina M Sequeira
- Center for Adolescent & Young Adult Health, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Calvin McMillan
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Galen Switzer
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Dana Rofey
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- Center for Adolescent & Young Adult Health, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gerald T Montano
- Center for Adolescent & Young Adult Health, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Flujas-Contreras JM, García-Palacios A, Gómez I. Effectiveness of a Web-Based Intervention on Parental Psychological Flexibility and Emotion Regulation: A Pilot Open Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2958. [PMID: 33805835 PMCID: PMC7998718 DOI: 10.3390/ijerph18062958] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 01/07/2023]
Abstract
"Parenting Forest" is an informed contextual therapy parenting program for improving parental emotion regulation strategies and psychological flexibility. The aim of this study was to evaluate the preliminary effectiveness of a self-guided web-based intervention of the Parenting Forest program. The intervention program consists of six self-applied sequential modules that use strategies from contextual therapies for providing a parenting style open to experience, mindful and committed to its actions. A pilot controlled open trial was conducted. Eligible parents (n = 12) enrolled in the web-based intervention completed baseline (T1) and post-intervention (T2) assessment instruments. Parental psychological flexibility, avoidance, emotional regulation, parental stress, satisfaction with life, children's psychological adjustment and client satisfaction were measured to assess the effects of the intervention. Mood, coping, and value-related actions were assessed as measures of progress. The results showed positive effects on the parents' psychological flexibility and emotion regulation. Parents' mood and coping skills improved throughout the intervention program. These results provide preliminary evidence of the web-based Parenting Forest's efficacy, although further research is needed to assess its effectiveness for prevention and in clinical populations.
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Affiliation(s)
- Juan M. Flujas-Contreras
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
| | - Azucena García-Palacios
- Department of Psychology, University Jaume I, 12071 Castellon, Spain;
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Inmaculada Gómez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain;
- Health Research Centre (CEINSA/UAL), University of Almeria, 04120 Almeria, Spain
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Papadopoulos D. Mothers' Experiences and Challenges Raising a Child with Autism Spectrum Disorder: A Qualitative Study. Brain Sci 2021; 11:309. [PMID: 33801233 PMCID: PMC8001702 DOI: 10.3390/brainsci11030309] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/25/2022] Open
Abstract
Although the study of autism is burgeoning with important implications both for public health and society, there is little research exploring the experiences of raising a child with autism spectrum disorder (ASD) from the maternal perspective. The aim of this study was to investigate the lived experiences of mothers of children with ASD in Greece. Nine mothers of children with ASD were recruited and engaged in semistructured interviews. Transcripts of the interviews were analyzed using interpretative phenomenological analysis. Three interconnected themes were identified in the analysis: (a) emotional burden, (b) family burden, and (c) social burden. A key finding in the themes was the sense of burden, distress, and vulnerability experienced by the mothers. The findings provide valuable understanding of the experiences of mothers raising children with ASD in one of Europe's medium-income countries. Further, results can be used by researchers, clinicians, mental health providers, and policy makers to address the unique needs of families caring for and supporting children with ASD.
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Affiliation(s)
- Dimitrios Papadopoulos
- Department of Psychology, Gallos University Campus, University of Crete, 74100 Rethymno, Greece;
- Child and Adolescent Mental Health Service, Panhellenic Association of Mental Health for Children and Adults, 17671 Athens, Greece
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30
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Jones G, Jassi A. Modified Cognitive Behavior Therapy for Severe, Treatment Resistant Obsessive-Compulsive Disorder in an Adolescent With Autism Spectrum Disorder: The Importance of Parental Involvement. J Cogn Psychother 2020; 34:319-335. [PMID: 33372126 DOI: 10.1891/jcpsy-d-20-00019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The prevalence of obsessive-compulsive disorder (OCD) is higher among young people with autism spectrum disorders (ASD). Case studies and randomized controlled trials show that modified cognitive behavioral therapy (CBT) can be effective for young people with OCD and co-morbid ASD. This case study describes modified CBT for an adolescent with severe, treatment-resistant OCD and co-morbid ASD, and highlights the importance of family accommodation and parental mental health in pediatric OCD. Modifications to the standard evidence-based CBT for OCD protocol included extended psychoeducation, visual session material, mini exposure and response prevention hierarchies and parallel parent sessions to address familial accommodation and parental mental health. Progress was measured at seven times points throughout treatment using clinician administered, youth and parent self-report measures. Outcome data indicated significant improvements in OCD symptoms, general functioning, and maternal mental health as well as significant reductions in family accommodation. Gains were maintained over a 12-month follow-up period. This case study illustrates that modified CBT can be effective in youth with OCD and ASD and discusses the importance of familial accommodation and parental mental health.
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Affiliation(s)
- Gazal Jones
- National Specialist Clinic for Young People With OCD, BDD and Related Disorders, South London, and Maudsley NHS Foundation Trust, London, UK
| | - Amita Jassi
- National Specialist Clinic for Young People With OCD, BDD and Related Disorders, South London, and Maudsley NHS Foundation Trust, London, UK
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31
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Bountress KE, Gilmore AK, Metzger IW, Aggen SH, Tomko RL, Danielson CK, Williamson V, Vladmirov V, Ruggiero K, Amstadter AB. Impact of disaster exposure severity: Cascading effects across parental distress, adolescent PTSD symptoms, as well as parent-child conflict and communication. Soc Sci Med 2020; 264:113293. [PMID: 32858492 PMCID: PMC7689632 DOI: 10.1016/j.socscimed.2020.113293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/16/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Natural disasters are common and have potentially deleterious impacts on individuals, as well as on the relationships among family members (Adams et al., 2015; Paul, 2015). Additionally, caregiver-, offspring-, and family-level outcomes are often correlated following disaster. OBJECTIVE Thus, longitudinal work is needed to clarify the prospective associations among such constructs following severe disasters. METHOD The current study included 1,271 adolescents and investigated whether disaster exposure impacted adolescent posttraumatic stress disorder (PTSD) symptoms, parent distress, and family parent-child conflict and communication, as well as whether/how these factors influenced one another over time. This study used a dynamic cascade model and included adolescents (ages 12-17) and caregivers present for tornadoes in Missouri and Alabama in 2011. These participants were part of a larger study involving a web-based intervention. RESULTS Over and above covariates (i.e., adolescent age, gender, race, treatment, prior trauma, adolescent alcohol use and depressive symptoms, and household income), families who experienced greater severity of disaster exposure had adolescents who reported more baseline PTSD symptoms and caregivers who reported more distress at baseline. CONCLUSIONS Providing tangible resources (e.g., housing, food, transportation, essential possessions) to families post-disaster may reduce parent distress and adolescent PTSD symptoms. Additionally, reducing adolescent PTSD symptoms may prospectively improve relationships between parents and adolescents.
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Affiliation(s)
- Kaitlin E Bountress
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States.
| | - Amanda K Gilmore
- Mark Chaffin Center for Healthy Development and Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, United States
| | - Isha W Metzger
- University of Georgia, Department of Psychology, United States
| | - Steven H Aggen
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Rachel L Tomko
- Addiction Sciences Division, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Carla Kmett Danielson
- National Crime Victim Research & Treatment Center (NCVC), Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Vernell Williamson
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Vladimir Vladmirov
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Kenneth Ruggiero
- College of Nursing, Medical University of South Carolina, United States
| | - Ananda B Amstadter
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
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32
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Examining the correlates of psychological flexibility in romantic relationship and family dynamics: A meta-analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hong SW, Kim J, Bang HL. Validity and Reliability of the Life Transition Scale in Parents of Disabled Children Across the Life Transition Process. CHILD HEALTH NURSING RESEARCH 2020; 26:338-347. [PMID: 35004477 PMCID: PMC8650974 DOI: 10.4094/chnr.2020.26.3.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/12/2022] Open
Abstract
Purpose The Life Transition Scale (LTS) consists of 24 items that assess the life transition process of parents of autistic children. This study aimed to examine the validity and reliability of the LTS in parents of children with a wide spectrum of disabilities. Methods Data were collected from 260 parents of children with disabilities through self-report questionnaires. Validity was examined using exploratory and confirmative factor analysis to determine the factor structures of the LTS; socio-demographic differences in LTS scores were examined using the t-test or ANOVA. Reliability was examined using Cronbach's ⍺ coefficient. Results A four-factor structure was validated (x2=640.0, p<.001, GFI=.81, RMSEA=.07, NNFI=.89, CFI=.89, PNFI=.74, Q [x2/df]=2.60). The validity of the LTS was verified by exploratory factor analysis, with factor loading ranging from .30 to .80. There were significant differences in the accepting phase according to children's and parents' age and the type of disability, and in the wandering phase according to parental gender, educational level, job, and socioeconomic status. The Cronbach's ⍺s for the reliability of each of the four structures were acceptable, within a range of .80~.90. Conclusion The LTS is a valid and reliable measurement to assess the life transition process of parents with disabled children.
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Affiliation(s)
- Sun Woo Hong
- Associate Professor, Department of Emergency Medical Services, Daejeon University, Daejeon, Korea
| | - JinShil Kim
- Professor, College of Nursing, Gachon University, Incheon, Korea
| | - Hwal Lan Bang
- Assistant Professor, Department of Nursing, Andong National University, Andong, Korea
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Improving Service Access in ASD: A Systematic Review of Family Empowerment Interventions for Children with Special Healthcare Needs. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00208-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hemati Alamdarloo G, Majidi F. Feelings of hopelessness in mothers of children with neurodevelopmental disorders. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:485-494. [PMID: 35937174 PMCID: PMC9351562 DOI: 10.1080/20473869.2020.1736886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 06/15/2023]
Abstract
The aim of the present study was to compare feelings of hopelessness in mothers of children with neurodevelopmental disorders. The statistical population of the study included all mothers of children with neurodevelopmental disorders in Shiraz, Iran. The sample consisted of 150 mothers of children with neurodevelopmental disorders, including 50 mothers of children with autism spectrum disorder (ASD), 50 mothers of children with intellectual disability (ID), and 50 mothers of children with specific learning disorder (SLD) and they were selected by convenience sampling method. The data were collected during the years 2015-2016. The Beck Hopelessness Scale (BHS; Beck et al.) was used for measuring the feelings of hopelessness. The one-way ANOVA and MANOVA tests were used for the data analysis. The results showed that the feelings of hopelessness and the two subscales of feelings of hopelessness, i.e. negative expectations of the future and the loss of motivation in association with the future, in mothers of children with ASD were significantly higher than those of the other two groups of mothers. It was also observed that mothers of children with ID, compared to mothers of children with SLD, had higher levels of feelings of hopelessness, negative expectations of the future, and negative feelings in association with the future. Additionally, the findings revealed that mothers of children with ASD, compared to mothers of children with SLD, had higher levels of negative feelings in association with the future. Therefore, adopting preventive and intervention programs which can help mothers of children with neurodevelopmental disorders, especially mothers of children with ASD, to overcome their feelings of hopelessness are of great importance.
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Affiliation(s)
| | - Farzad Majidi
- Special Education Department, Shiraz University, Shiraz, Iran
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36
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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.
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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
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Carlier S, Van der Paelt S, Ongenae F, De Backere F, De Turck F. Empowering Children with ASD and Their Parents: Design of a Serious Game for Anxiety and Stress Reduction. SENSORS 2020; 20:s20040966. [PMID: 32054025 PMCID: PMC7070716 DOI: 10.3390/s20040966] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/27/2020] [Accepted: 02/07/2020] [Indexed: 12/22/2022]
Abstract
Autism Spectrum Disorder (ASD) is characterized by social interaction difficulties and communication difficulties. Moreover, children with ASD often suffer from other co-morbidities, such as anxiety and depression. Finding appropriate treatment can be difficult as symptoms of ASD and co-morbidities often overlap. Due to these challenges, parents of children with ASD often suffer from higher levels of stress. This research aims to investigate the feasibility of empowering children with ASD and their parents through the use of a serious game to reduce stress and anxiety and a supporting parent application. The New Horizon game and the SpaceControl application were developed together with therapists and according to guidelines for e-health patient empowerment. The game incorporates two mini-games with relaxation techniques. The performance of the game was analyzed and usability studies with three families were conducted. Parents and children were asked to fill in the Spence’s Children Anxiety Scale (SCAS) and Spence Children Anxiety Scale-Parents (SCAS-P) anxiety scale. The game shows potential for stress and anxiety reduction in children with ASD.
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Affiliation(s)
- Stéphanie Carlier
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
- Correspondence:
| | - Sara Van der Paelt
- Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - Femke Ongenae
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
| | - Femke De Backere
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
| | - Filip De Turck
- IDLab, iGent Tower—Department of Information Technology, Ghent University—imec, Technologiepark-Zwijnaarde 126, B-9052 Ghent, Belgium
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Bejarano-Martín Á, Canal-Bedia R, Magán-Maganto M, Fernández-Álvarez C, Cilleros-Martín MV, Sánchez-Gómez MC, García-Primo P, Rose-Sweeney M, Boilson A, Linertová R, Roeyers H, Van der Paelt S, Schendel D, Warberg C, Cramer S, Narzisi A, Muratori F, Scattoni ML, Moilanen I, Yliherva A, Saemundsen E, Loa Jónsdóttir S, Efrim-Budisteanu M, Arghir A, Papuc SM, Vicente A, Rasga C, Rogé B, Guillon Q, Baduel S, Kafka JX, Poustka L, Kothgassner OD, Kawa R, Pisula E, Sellers T, Posada de la Paz M. Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives. J Autism Dev Disord 2019; 50:3380-3394. [DOI: 10.1007/s10803-019-04253-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Kalleson R, Jahnsen R, Østensjø S. Empowerment in families raising a child with cerebral palsy during early childhood: Associations with child, family and service characteristics. Child Care Health Dev 2019; 46:19-27. [PMID: 31503355 DOI: 10.1111/cch.12716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/03/2019] [Accepted: 09/06/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Insight into family empowerment is important in order to develop and offer services that support and strengthen parents caring for a child with disability. The aims of this study were to describe empowerment trajectories among parents caring for a young child with cerebral palsy (CP) and to explore associations between parental empowerment and characteristics of the child and family and the services they receive. METHODS 58 children (median age at first assessment 28 months, range 12-57) and their parents were included in a longitudinal cohort study based on registry data from follow-up programs for children with CP in Norway. Parental empowerment trajectories were described by averaging scores in the three subscales of the Family Empowerment Scale (FES) (family, service situations and community) at enrollment and at semi-annual/annual assessments. A linear mixed model was used to explore associations. RESULTS Parental empowerment scores on the FES in family and service situations were high and stable during early childhood, while considerably lower in the community context. In service situations, perceived empowerment was significantly associated with both child, family and service characteristics, whereas empowerment in family situations was only associated with family characteristics. The service factor having a multidisciplinary support team was positively associated with perceived empowerment in both service situations and in the community. CONCLUSION Knowledge about parental empowerment in different contexts and associations with characteristics of the child and family and the services they receive can contribute to further reinforcing family empowerment and identifying parents in need of additional support.
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Affiliation(s)
- Runa Kalleson
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University
| | - Reidun Jahnsen
- Department of Clinical Neuroscience for Children, Oslo University Hospital
- Institute of Health and Society, University of Oslo
| | - Sigrid Østensjø
- Department of Physiotherapy, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University
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Sairanen E, Lappalainen R, Lappalainen P, Kaipainen K, Carlstedt F, Anclair M, Hiltunen A. Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cook T, Noone S, Thomson M. Mindfulness-based practices with family carers of adults with learning disability and behaviour that challenges in the UK: Participatory health research. Health Expect 2019; 22:802-812. [PMID: 31187580 PMCID: PMC6737767 DOI: 10.1111/hex.12914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/07/2019] [Accepted: 04/30/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Family carers of adults with learning disability and behaviours that challenge lead complex and stressful lives. Their caring role can leave them isolated and unsupported. In the UK, effective services designed to build resilience for people in long-term caring roles are lacking. There are none (to our knowledge) designed using a participatory health research (PHR) approach with family carers and professionals. OBJECTIVE With positive behaviour support (PBS) and mindfulness and acceptance and commitment therapy (ACT) as key elements, a PHR approach was used to understand the basis for a successful course that supported the capabilities and resilience of family members in long-term caring roles. DESIGN The research was guided by the principles of PHR with participation as the defining principle throughout. Central to the research were reflexive conversations (communicative spaces) where diverse knowledges were shared and critiqued. FINDINGS Mindfulness/ACT can change long-standing response behaviours and build personal resilience and improve mental health. Elements enabling positive change included a facilitation approach for collaborative reflexivity and the complementary, interactive approach to collaborative enquiry for learning and decision making afforded by PHR. DISCUSSION The use of PHR accessed knowledges that would have been lost to more traditional, professional-expert driven processes and facilitated change in constructs for action for both professionals and family carers. Findings challenge service providers to consider how experiential knowledge has agency in professional practice and service design. Reflection on the PHR process across the FaBPos project led to a re-consideration of quality issues in relation to PHR and participation.
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Affiliation(s)
- Tina Cook
- Department of Disability and Education, Liverpool Hope University, Liverpool, UK
| | - Steven Noone
- Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, UK
| | - Megan Thomson
- Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, UK
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The Relationship Between Social Affect and Restricted and Repetitive Behaviors Measured on the ADOS-2 and Maternal Stress. J Autism Dev Disord 2019; 48:751-758. [PMID: 29322384 DOI: 10.1007/s10803-017-3453-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study investigated categories of autism spectrum disorder (ASD) symptoms measured by the Autism Diagnostic Observation Schedule-Second Edition and their association with maternal stress. Social affect and restricted and repetitive behaviors were compared with levels of maternal stress, measured by the Parenting Stress Index, in 102 children with ASD ages 2-12 years of age. Results indicated that social affect and restricted and repetitive behaviors were associated with the mother's stress regarding acceptability of the child's condition. Additionally, restricted and repetitive behaviors were significantly related to stress involving the child's hyperactivity and impulsivity. These findings highlight specific areas of stress experienced by mothers of children with ASD that are related to the child's symptoms, providing information for caregiver support and intervention.
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Ashcraft LE, Asato M, Houtrow AJ, Kavalieratos D, Miller E, Ray KN. Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies. THE PATIENT 2019; 12:199-212. [PMID: 30328069 PMCID: PMC6397702 DOI: 10.1007/s40271-018-0336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established. OBJECTIVE The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. ELIGIBILITY CRITERIA The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies. INFORMATION SOURCES We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists. INCLUDED STUDIES Forty-four articles met the inclusion criteria. SYNTHESIS OF RESULTS We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation. STRENGTHS AND LIMITATIONS OF EVIDENCE Non-English articles were excluded. INTERPRETATION Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents. CLINICAL REGISTRATION NO PROSPERO 2017:CRD42017059478.
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Affiliation(s)
- Laura Ellen Ashcraft
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
- University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
| | - Miya Asato
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Amy J Houtrow
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dio Kavalieratos
- Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Kristin N Ray
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Hahs AD, Dixon MR, Paliliunas D. Randomized controlled trial of a brief acceptance and commitment training for parents of individuals diagnosed with autism spectrum disorders. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2018.03.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Miranda A, Mira A, Berenguer C, Rosello B, Baixauli I. Parenting Stress in Mothers of Children With Autism Without Intellectual Disability. Mediation of Behavioral Problems and Coping Strategies. Front Psychol 2019; 10:464. [PMID: 30906274 PMCID: PMC6418028 DOI: 10.3389/fpsyg.2019.00464] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/15/2019] [Indexed: 11/29/2022] Open
Abstract
The present study investigated the mediating role of behavioral difficulties, coping strategies, and social functional support in the relationship between symptoms severity and parenting stress in mothers of children with ASD (autism spectrum disorder). The parenting stress questionnaire, coping orientation to problems experienced scale, strengths and difficulties questionnaire, and Duke-UNC social support questionnaire were administered to 52 mothers, who also estimated the ASD severity symptoms of their children. Correlation analyses revealed that parenting stress was positively correlated with the children's ASD symptoms and behavioral problems. On the other hand, parenting stress was negatively correlated with the engagement coping and social functional support reported by the mothers. Multiple mediation analysis indicated that engagement coping and behavioral difficulties were significant mediators in the relationship between ASD symptoms and parenting stress, with the engagement variable having a larger effect. The findings illustrate the need to promote the mothers' engagement coping orientation and the application of behavioral strategies with their children to help them to buffer the impact of stress.
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Affiliation(s)
- Ana Miranda
- Departamento de Psicología evolutiva y de la educación, Universitad de Valencia, Valencia, Spain
| | - Alvaro Mira
- Departamento de Psicología evolutiva y de la educación, Universitad de Valencia, Valencia, Spain
| | - Carmen Berenguer
- Departamento de Psicología evolutiva y de la educación, Universitad de Valencia, Valencia, Spain
| | - Belen Rosello
- Departamento de Psicología evolutiva y de la educación, Universitad de Valencia, Valencia, Spain
| | - Inmaculada Baixauli
- Departamento de Ciencias de la ocupación, logopedia, psicología evolutiva y de la educación, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Zhou Y, Yin H, Wang M, Wang J. The effect of family-focused psychoeducational therapy for autism spectrum disorder children's parents on parenting self-efficacy and emotion. Arch Psychiatr Nurs 2019; 33:17-22. [PMID: 30663619 DOI: 10.1016/j.apnu.2018.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/17/2018] [Accepted: 08/04/2018] [Indexed: 11/18/2022]
Abstract
The purpose of this pilot study was to design, implement, and evaluate the family-focused psychoeducational therapy (FFPT) for autism spectrum disorder (ASD) family. In Phase I, 64 parents of ASD children (ASD-group) and 63 parents of typically development children (TD-group) were invited to investigate parenting self-efficacy and emotion at baseline. In Phase II, the 4-week of FFPT was offered for the ASD-group. Date was collected at baseline, post-intervention and one-month follow-up, using the parental self-efficacy, Self-Rating Anxiety Scale and Self-Rating Depression Scale. The results showed that ASD-group significantly lower levels of parenting self-efficacy and worse emotion than TD-group (p < 0.05); And after attending the program, ASD-group had significant improvements for all outcome measures and these changes maintained over a period of time (p < 0.05). This preliminary study suggests that the FFPT may effectively improve parenting self-efficacy, reduce anxiety and depression for parents of children with ASD.
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Affiliation(s)
- Yating Zhou
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Huaying Yin
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
| | - Minjian Wang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Juan Wang
- Department of Child Health Care, Children's Hospital of Chongqing Medical University, No.136, 2nd Zhongshan Road, Yuzhong District, Chongqing, China; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
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Shochet IM, Saggers BR, Carrington SB, Orr JA, Wurfl AM, Duncan BM. A Strength-Focused Parenting Intervention May Be a Valuable Augmentation to a Depression Prevention Focus for Adolescents with Autism. J Autism Dev Disord 2019; 49:2080-2100. [DOI: 10.1007/s10803-019-03893-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Ilias K, Cornish K, Park MSA, Toran H, Golden KJ. Risk and Resilience Among Mothers and Fathers of Primary School Age Children With ASD in Malaysia: A Qualitative Constructive Grounded Theory Approach. Front Psychol 2019; 9:2275. [PMID: 30670992 PMCID: PMC6331527 DOI: 10.3389/fpsyg.2018.02275] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 11/01/2018] [Indexed: 12/03/2022] Open
Abstract
Little is known about the coping and resilience experiences of parents of children with autism spectrum disorder (ASD) in the Malaysian cultural context. This study utilized a qualitative methodological approach adopting constructive grounded theory. The study sought to address the lack of research to date exploring the risk and protective experiences that contribute to parental stress and resilience for parents of primary school age children with ASD in the Malaysian setting. Twenty-two parents of children with ASD (13 mothers and 9 fathers) participated in semi-structured interviews. A strength of the study was the inclusion of both mother and father participant perspectives. The interviews lasted 50-80 min (mean: 67.5 min). The 22 parents had a total of 16 children (12 males; 4 females) formally diagnosed with ASD. Child age ranged between 5 and 12 years (mean age: 8.44). Overall, analysis of the 22 interviews revealed four prominent themes - "initial reaction to child's ASD symptoms and diagnosis," "family life affected by a child with ASD," "awareness about ASD in Malaysia," and "coping strategies, wellbeing, and becoming resilient." The first three themes revolved around stress and adversity, and, the adaptability and acceptance of the parents. These processes illustrated the risks experienced by the parents of children with ASD in Malaysia. The last theme especially highlighted the strengths and determination of the parents and illustrated the protective experiences and processes that helped parents to develop and enhance resilience. Overall, the findings revealed that resilience develops synergistically and dynamically from both risk and protective experiences across different levels - individual, family, community, society and government. The findings motivated the development of our theoretical model of resilience that can help health and education professionals tailor assessment and interventions for parents of children with ASD in the Malaysian context. Clinical, policy, and research suggestions were discussed.
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Affiliation(s)
- Kartini Ilias
- Jeffrey Cheah School of Medicine and Health Sciences, Global Asia in the 21st Century Research Platform (GA21), Monash University Malaysia, Subang Jaya, Malaysia
- Department of Basic Sciences, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Malaysia
| | - Kim Cornish
- School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Miriam Sang-Ah Park
- Jeffrey Cheah School of Medicine and Health Sciences, Global Asia in the 21st Century Research Platform (GA21), Monash University Malaysia, Subang Jaya, Malaysia
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Hasnah Toran
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Karen Jennifer Golden
- Jeffrey Cheah School of Medicine and Health Sciences, Global Asia in the 21st Century Research Platform (GA21), Monash University Malaysia, Subang Jaya, Malaysia
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Increasing Access to Empirically-Validated Interventions for Autism Spectrum Disorder:: Dissemination of PEERS into Community Health Settings. Dela J Public Health 2018; 4:52-60. [PMID: 34467002 PMCID: PMC8352447 DOI: 10.32481/djph.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives This research project aims to build capacity for social skills interventions for ASD for adolescents in community mental health settings in Delaware, using The Program for the Education and Enrichment of Relational Skills (PEERS), a social skills group program developed at UCLA. Methods Aim 1: A two-day education on PEERS was provided to community clinicians (n=15), and clinicians completed a survey assessing their perception of implementing a social skills group intervention for families at three time points. Aim 2: Five PEERS groups were held at three community mental health locations. Caregivers (n=14) completed rating scales assessing family quality of life, social skills, or parenting stress. Results Clinicians reported increased confidence in their ability to deliver social skills intervention following two-day education on PEERS. Furthermore, the clinicians who facilitated a PEERS group (n=9) reported a clinically significant increase in confidence. Fourteen families completed PEERS; no difference was reported regarding family quality of life, social skills, or parenting stress. Conclusions This study shows the feasibility of expanding social skills interventions for children and families affected by ASD into community mental health settings, as 15 clinicians received additional education regarding social skills interventions and five more group opportunities using the PEERS program were made available in the community.
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Wheeler AC, Miller S, Wylie A, Edwards A. Mindfulness and Acceptance as Potential Protective Factors for Mothers of Children With Fragile X Syndrome. Front Public Health 2018; 6:316. [PMID: 30460222 PMCID: PMC6232517 DOI: 10.3389/fpubh.2018.00316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 10/15/2018] [Indexed: 11/13/2022] Open
Abstract
Women with an FMR1 premutation may be at increased genetic risk for stress vulnerability. This increased vulnerability, when combined with stressful parenting that can result from raising children with fragile X syndrome (FXS), may result in negative physical and emotional outcomes. Mindfulness and acceptance have been found to be protective factors for parents of children with similar behavioral challenges, but these traits have not previously been explored among mothers with a child with FXS. This study explored the associations of child disability severity with maternal stress, anxiety, depression, and physical health symptoms in 155 biological mothers of children with FXS. Women completed an online survey using standardized measures of stress, mindfulness, and acceptance. General mindfulness, mindfulness in the parenting role, and general acceptance were explored as potential protective factors between the child disability severity and maternal outcomes. Trait mindfulness and acceptance were significant predictors of lower stress, anxiety, depression, and daily health symptoms, while mindful parenting was associated with lower stress, anxiety, and depression. Acceptance was found to attenuate the effects of child severity on maternal stress and depression. These findings suggest that interventions focused on improving mindfulness and acceptance may promote health and well-being for mothers of children with FXS and have important health implications for all individuals with an FMR1 premutation.
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