Perceived self-efficacy in parents of adolescents and adults with autism spectrum disorder

Self-compassion, mental health, and parenting: Comparing parents of autistic and non-autistic children

LAY ABSTRACT

Parenting can be challenging for any parent, particularly for those parenting autistic children. Research has shown that being kind, accepting, and mindful toward oneself during suffering, a concept known as self-compassion, can help enhance mental health. However, it is not fully understood how self-compassion benefits parenting experiences for parents of autistic children. Therefore, we conducted a study involving 178 parents of autistic children and 178 of autistic children to explore the associations between self-compassion, mental health, and parenting experiences. We found that parents of autistic children reported less self-compassion compared to parents of non-autistic children. For both groups of parents, self-compassion was linked to lower levels of ill-being and parenting stress, as well as higher levels of well-being and parenting competence. In parents of non-autistic children, both ill-being and well-being played a mediating role in the relationship between self-compassion and parenting experiences. However, in parents of autistic children, only well-being was found to mediate this relationship. These findings emphasize the importance of self-compassion and well-being in improving parenting experiences for parents of autistic children.

Are a Child's Autistic Traits, Behavioural Difficulties, Prosocial Behaviour and Temperament Predictors of Parental Self-Efficacy and Satisfaction? A Study on Parents of Autistic and Neurotypical Children Aged 7-11 Years

The aim of the study was to evaluate the significance of the severity of autistic traits, behavioural difficulties, prosocial behaviour and temperamental characteristics in children for parental self-efficacy and parental satisfaction in two groups of parents: parents of autistic children, and parents of neurotypical children. Data come from 145 parents of autistic children and 239 parents of neurotypical children. Using hierarchical multiple regression analyses, the analysis explored the role of child characteristics in prediction of parental self-efficacy and parental satisfaction. The regression model tested explained 21% variation in parental self-efficacy and 27% variation in parental satisfaction in parents of autistic children and 3% of variation of results with respect to parental self-efficacy and 17% variation in parental satisfaction in parents of neurotypical children. In both groups, parental self-efficacy and parental satisfaction were negatively correlated with such child characteristics as severity of behavioural difficulties, severity of autistic traits and emotionality as also positively related to the child's prosocial behaviour. These findings may suggest that particularly useful mental health prevention programs for parents should combine two elements: developing parents' abilities of effectively coping with children's behavioural difficulties and working on attribution processes and negative convictions about parenthood.

A Systematic Review of Parental Self-Efficacy in Parents of Autistic Children

Parental self-efficacy (PSE) assesses a parent's expectations and beliefs about their ability to effectively parent their child. PSE has implications for a parent's well-being, parenting practices, mental health, the parent-child relationship, and child adjustment. While PSE has been extensively examined within the broader parenting literature, the examination of PSE specifically for parents of autistic children has gained increasing attention in recent years. The following systematic review aimed to investigate the role of PSE for parents of autistic children by examining variables that predict PSE or are predicted by PSE in relation to how they align with the broader parenting literature and are unique to autism. Utilizing PRISMA guidelines, peer-reviewed articles were included if (a) participants included caregivers of autistic children, (b) at least one quantitative outcome measure of PSE was utilized, and (c) the role of PSE was examined as an outcome, predictor, or variable in an explanatory model. A total of 53 studies were included in the review and the role of PSE was examined regarding family (e.g., parental characteristics, parent stress, well-being, and support) and child factors (e.g., autism symptomology, problem behaviors, interventions). Several themes emerged including a positive relationship between PSE and support, and a negative relationship between PSE and parenting stress, parent mental health outcomes (e.g., anxiety, depression), and autism symptomology. Findings were compared to the broader parenting and PSE literature to examine how increased considerations and challenges (e.g., child problem behaviors, social impairment, and caregiver strain) associated with raising an autistic child might impact PSE.

Service access experiences of immigrant and refugee caregivers of autistic children in Canada: A scoping review

Primary caregivers are the main mediators of care for children with an autism diagnosis in Canada, and the navigation process to gain access to autism-related services is known to be a major burden. These challenges to service access are compounded for newcomers to Canada, which include immigrants and refugees. The purpose of this scoping review is to describe the available research on Canadian newcomer caregiver experiences navigating and accessing autism-related services. After a systematic search and screening process, 28 studies were included. Data were extracted regarding the populations, study aims, and themes reported. Included studies characterized barriers and facilitators to service access and navigation specific to immigrants, while limited information was available for refugees. Based on the existing literature, the authors provide recommendations for possible research approaches, populations to include, and themes to examine in future research to promote health equity in Canadian autism service access.

Parenting self-efficacy instruments for parents of infants and toddlers: A review

Background

Parenting Self-Efficacy, a concept first described in Bandura's Social Cognitive Theory, is a parent's belief in their ability to successfully parent their child. The concept of parenting self-efficacy is used by researchers to increase our understanding of parenting abilities and influences on child health and developmental outcomes. Numerous instruments exist for measuring parental self-efficacy; but little is known about the specific topics included in the measures and consistency across instruments. Therefore, this scoping review sought to compare parenting self-efficacy instruments for parents of infants and toddlers, focusing on comparison of parenting topics, scale format, and administration with the goal of providing guidance and recommendations for measurement selection.

Methods

Our sample included 25 instruments and items from every instrument was evaluated and coded using NVIVO Qualitative Software. We reviewed the instruments' target population, subscales, number of items, response options, scoring range and instructions, theoretical background, and parenting topics across each instrument.

Results

This review found three common factors across all instruments: parent, social and family, and child factors. Parent personal factors were addressed most frequently to evaluate self-efficacy and included topics such as, perception of parenting abilities, emotional reactions, and perceived successes. From our synthesis, we also offer recommendations for instrument selection and provide a conceptual model of parenting self-efficacy.

Conclusions

The findings from this scoping review highlight the presence of key factors (parent, social & family, and child) necessary for the evaluation of parenting self-efficacy in parents of infants and toddlers. Given our results, a meta-analysis is needed to compare parenting self-efficacy scores across studies to better understand the associations between self-efficacy and parent and child outcomes.

Building Self-Efficacy in Parenting Adult Children With Autistic Spectrum Disorder: An Initial Investigation of a Two-Pronged Approach in Role Competence

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.

Sense of Parenting Efficacy, Perceived Family Interactions, and Parenting Stress Among Mothers of Children With Autistic Spectrum Disorders

This study examined the relationship between maternal sense of parenting efficacy and parental stress in children with autism and the moderating effect of family interaction. A total of 263 mothers of children with autism were investigated with the Parenting Ability Scale, Family Interaction Scale (FIS), and Parental Stress Scale. The results showed that (1) maternal sense of parenting efficacy significantly predicted parental stress in children with autism; and (2) family interaction significantly moderated the relationship between maternal sense of parenting efficacy and parental stress in children with autism, that is, when family interaction was lower than -1.54 standard deviation (SD), the sense of parenting efficacy did not significantly predict parental stress. When family interaction was higher than -1.54 SD, parenting efficacy had a significant negative predictive effect on parenting stress.

Correlates of Parents’ Readiness towards Inperson Schooling among Senior High School Students during COVID-19 Pandemic in Central Java, Indonesia

During the COVID-19 pandemic, in-person schoolings has been allowed since July 2021, especially for senior high schools. However, school clusters of COVID-19 happened in Central Java Province. This study aimed to analyze factors correlated to parents’ readiness toward in-person schooling during the COVID-19 pandemic. A cross-sectional study was conducted for 2 weeks on June-July 2021. The population was parents with senior high school students in Central Java Province. The questionnaire's link was shared through Education Office’s parents’ networks throughout Central Java. There were 1,520 respondents participated. Most respondents permit their children to in-person schooling (75.66%). Respondents were from 14 cities in Central Java, and most of them were from Pemalang (41.1%). Most respondents have good knowledge of COVID-19 (73.3%), good perception of COVID-19 (59.4%), high self-efficacy (57.2%), and sufficient parents’ readiness (64.4%). The Chi-Square test showed that education level (p=0.000), occupation (p=0.008), city of origin (p=0.000), and self-efficacy (p=0.000) were correlated to parents’ readiness. The multivariate analysis showed that education level (OR=1.246), occupation (OR=0.683), city of origin (OR=1.032), and self-efficacy (OR=1.263) affecting parents’ readiness. After controlling the education level, occupation, and city of origin, self-efficacy remains contributing to parents’ readiness for in-person schooling.

Emotion transformation: a grounded theory for uncovering painful triggers and repairing relational connection for parents of autistic children

Purpose

It is often voiced that parents of autistic children are the expert of their child, whereas parenting programmes target them as effective mediators for change. This paper aims to explore this unchallenged heuristic to develop an understanding of both emotional and relational needs of parents through trainers’ experiences of delivering emotion-focused and autism parent training.

Design/methodology/approach

This qualitative study used a constructivist approach of grounded theory to gain an in-depth understanding of trainers’ experiences from their encounters when delivering parent training. Six expert trainers were interviewed, and a two-phased coding of ground theory and an adapted thematic analysis was used.

Findings

An overarching theme emerged: emotion transformation from painful triggers, to enhanced attunement and relational repair. Four main themes containing 13 subthemes were identified. The interaction of these themes and subthemes are presented in a three-phase process model. Phase 1: uncovering painful emotions from a shared journey contained one theme: parent painful triggers. Phase 2: uncovering interpersonal rupture cycle contained one theme: relational rupture cycle within non-synchrony of attunement. Phase 3: parent–child relational repair contained two themes: repairing attachment bonds and therapist’s prizing stance.

Social implications

The authors challenge the parent as expert heuristic and propose that not all parents feel expert in neurotypical-neurodivergent intersubjectivity. The authors are curious to see whether trainers/therapists can guide parents through unprocessed emotions and non-synchrony of attunement to promote healing and relational repair, which requires further investigation.

Originality/value

To the best of the authors’ knowledge, this is the first emotion-transformation process model grounded in humanistic principles of relational acceptance and emotion theory. The authors propose that a focus on process rather than outcome is more likely to result in higher parenting self-efficacy.

Dyadic coping and coparenting among couples after their child's recent autism diagnosis

LAY ABSTRACT

We investigated how couples support each other after their child's autism diagnosis and whether this affects the way they work together to raise their child. We recruited 70 couples raising a child on the autism spectrum. Both partners were asked to complete the same questionnaires measuring how they perceived the experience of having a child on the autism spectrum, how they used their relationship to support each other during stressful situations, how competent they felt completing their parenting tasks, and the coparenting relationship to explore how they worked together as a team when parenting their child. Parents participated in the study 1-36 months after their child's autism diagnosis. We used statistical techniques that allowed us to see the impact mothers and fathers had on each other. Overall, parents who felt more competent and supported by their partner worked better as a team to raise their child on the spectrum. Fathers invested in the coparenting relationship more when mothers felt more supported by fathers. Mothers invested in the coparenting relationship more when fathers felt more competent parenting their child. Further research is needed to better understand how we can support couples as their child gets older.

Impact of the COVID-19 Italian Lockdown on the Physiological and Psychological Well-Being of Children with Fragile X Syndrome and Their Families

On 10 March 2020, in Italy, a total lockdown was put in place to limit viral transmission of COVID-19 infection as much as possible. Research on the psychological impact of the COVID-19 pandemic highlighted detrimental effects in children and their parents. However, little is known about such effects in children with neurodevelopment disorders and their caregivers. The present study investigated how the lockdown has impacted the physiological and psychological well-being of children with Fragile X-Syndrome (FXS), aged from 2 to 16 years, and their mothers. In an online survey, 48 mothers of FXS children reported their perception of self-efficacy as caregivers and, at the same time, their children’s sleep habits, behavioral and emotional difficulties during, and retrospectively, before the lockdown. Results showed a general worsening of sleep quality, and increasing behavioral problems. Although mothers reported a reduction in external support, their perception of self-efficacy as caregivers did not change during the home confinement compared to the period before. Overall, the present study suggested that specific interventions to manage sleep problems, as well as specific therapeutic and social support for increasing children and mother psychological well-being, need to be in place to mitigate the long-term effects of a lockdown.

Predicting the Outcomes of Parents of Transition-Age Youth or Young Adults with ASD

The transition outcomes for individuals with autism spectrum disorder (ASD) and their families are less than desirable. A survey of parent stressors, resources, coping/appraisals, and adaptation to transition was completed by 226 parents. The mediating mechanisms between stressors and parent outcomes were identified. At the indicator level, three stressors (i.e., autism severity, mental health crisis/challenging behaviors, and filial obligation), four resources (i.e., general social support, transition planning quality, parent-teacher alliance, and parenting efficacy), and three coping styles (i.e., problem-focused coping, avoidance-focused coping, and optimism) predicted parents' outcomes (i.e., burden, transition experience, subjective health, and quality of life). At the structural level, optimism, emotion-coping strategies, and resources mediated the relationships between stressors and parental outcomes. Research and practical applications are discussed.

Prospective College Students With Autism Spectrum Disorder: Parent Perspectives

Young adults with autism spectrum disorder (ASD) are attending university in increasing numbers. While those with ASD may be very knowledgeable within their chosen field, a range of academic-related and nonacademic challenges may hinder their success including executive functioning challenges and interpersonal issues. The purpose of this study was to conduct a preliminary investigation into the perspective of parents of high schoolers with ASD regarding their son/daughters' transition to college. Qualitative analysis of parent interviews examined the concerns and challenges they anticipated their son/daughter might experience in a university setting, as well as supports they are seeking as they consider postsecondary options. Prominent themes that emerged as areas of concern were social skills, executive functioning, academics, campus living, and support services. These findings highlight some key potential pitfalls for students with ASD which may be useful targets for prevention and remediation, as well as informing policy for colleges and universities as they consider cost-effective interventions to improve the academic success of students with ASD.

High Functioning Autism Spectrum Disorders in Adults: Consequences for Primary Caregivers Compared to Schizophrenia and Depression

Primary caregivers experience consequences from being in close contact to a person with autism spectrum disorder (ASD). This study used the Involvement Evaluation Questionnaire to explore the level of consequences of 104 caregivers involved with adults with High Functioning ASD (HF-ASD) and compared these with the consequences reported by caregivers of patients suffering from depression and schizophrenia. Caregivers involved with adults with an HF-ASD experience overall consequences comparable to those involved with patients with depression or schizophrenia. Worrying was the most reported consequence. More tension was experienced by the caregivers of ASD patients, especially by spouses. More care and attention for spouses of adults with an HF-ASD appears to be needed.

[The role of parental self-efficacy in the mental health of mothers of children with Congenital Zika Syndrome]

The article aimed to evaluate the mediating role of parental self-efficacy (PSE) between socioenvironmental factors and the mental health of the mothers of children with congenital zika syndrome (CZS). The socio-environmental factors were based on the cognitive and affective evaluation that people make of their context (subjective well-being, SWB) and fatigue. Sixty-six mothers with a mean age of 26.4 years of children with CZS in the state of Ceará, participated in this study. A questionnaire with the following scales was applied: Positive and Negative Affect Scale, Life Satisfaction Scale, Fatigue Evaluation Scale, General Health Questionnaire, Parental Self-efficacy Scale. The results indicated that the components of SWB, negative affects and life satisfaction, significantly predicted the mental health of mothers of children with CZS, and the PSE predicts better levels of mental health. It was observed that the PSE plays a mediating role in the relationship of satisfaction with life, negative effects and fatigue with mental health. PSE is an important psychological mechanism that acts as a mediator between the socio-environmental context and mental health. Thus, intervention strategies aimed at increasing the feelings of PSE in mothers can have a positive impact on the improvement of their mental health.

The effect of family-focused psychoeducational therapy for autism spectrum disorder children's parents on parenting self-efficacy and emotion

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.

The Impact of a School-Based Weight Management Program Involving Parents via mHealth for Overweight and Obese Children and Adolescents with Intellectual Disability: A Randomized Controlled Trial

There is a scarcity of resources and studies that utilize targeted weight management interventions to engage parents via mHealth tools targeting obese children and adolescents with mild intellectual disabilities (MIDs) extended from school to a home setting. To test the feasibility and acceptability of a school-based weight program (SBWMP) involving parents via mHealth tools designed to reduce weight, enhance knowledge and adopt healthy lifestyles, and thereby achieve better psychosocial well-being among children and adolescents with MIDs. Four special schools were randomly assigned as intervention or control schools. Students from the intervention group (n = 63) were compared to those in the control group (n = 52), which comprised those with usual school planned activities and no parental involvement. Demographics were considered as covariates in a general linear model, an ordinal regression model and a binary logistic regression model analyzing the relationships between the SBWMP and the outcome variables at baseline (T0) and six months later (T1). Body weight, body mass index, and triceps and subscapular skinfold thickness were lower in the intervention group compared to the control group, although the differences were not statistically significant. There was a positive and direct impact of the SBWMP on students' health knowledge and psychological impacts in the intervention group. The SBWMP extended to the home involving parents via mHealth tools is a feasible and acceptable program for this group with MIDs and their parents.

Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study

OBJECTIVES

To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD).

DESIGN

Prospective cohort study.

SETTING

Community-based study from Ontario, Canada.

PARTICIPANTS

Parents reported on their adult sons and daughters with ASD living in the community (n=284).

MAIN OUTCOME MEASURES

ED visits for any reason, ED visits for medical reasons and ED visits for psychiatric reasons over 1 year.

RESULTS

Among individuals with ASD, those with ED visits for any reason were reported to have greater family distress at baseline (p<0.01), a history of visiting the ED during the year prior (p<0.01) and experienced two or more negative life events at baseline (p<0.05) as compared with those who did not visit the ED. Unique predictors of medical versus psychiatric ED visits emerged. Low neighbourhood income (p<0.01) and living in a rural neighbourhood (p<0.05) were associated with medical but not psychiatric ED visits, whereas a history of aggression (p<0.05) as well as being from an immigrant family (p<0.05) predicted psychiatric but not medical emergencies.

CONCLUSIONS

A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.

'The dots just don't join up': Understanding the support needs of families of children on the autism spectrum

Much research has documented the elevated levels of stress experienced by families of autistic children. Yet remarkably little research has examined the types of support that these families perceive to be beneficial to their lives. This study, co-produced by researchers and school-based professionals, sought to establish these families' support needs from their own perspectives. In total, 139 parents of autistic children with additional intellectual disabilities and limited spoken communication, all attending an inner-city London school, participated in an initial survey examining parental wellbeing, self-efficacy and the extent to which they felt supported. Semi-structured interviews were conducted with a subgroup of parents ( n = 17), some of whom reported in the survey that they felt unsupported, in order to gain their in-depth perspectives. The results from both the survey and the interviews suggested that existing support (particularly from formal support services) was not meeting parents' needs, which ultimately made them feel isolated and alienated. Parents who were interviewed called for service provision that adopted a relational, family-centred approach - one that understands the specific needs of the whole family, builds a close working relationship with them and ensures that they are supported at times when the parents and families feel they need it most.

The Longitudinal Effects of Network Characteristics on the Mental Health of Mothers of Children with ASD: The Mediating Role of Parent Cognitions

Employing a cohort sequential design, the effects of network characteristics on maternal cognitions (perceived social support and parenting self-efficacy) and mental health (depression and well-being) were assessed over 7 years when children with ASD of mothers in the study were age 7-14. Findings indicated that network size, network emotional support, and network instrumental support were positively related to perceived support, while network availability and emotional support were positively linked to self-efficacy. In addition, network support exerted direct and indirect effects on maternal depression and well-being, with cognitive resources mediating the social network-mental health relationship. Finally, consistent with the support-efficacy model, parenting efficacy partially mediated the effects of perceived support on maternal mental health outcomes. Study findings and implications are discussed.

Barriers to healthcare: Instrument development and comparison between autistic adults and adults with and without other disabilities

Our objective was to use a community-based participatory research approach to identify and compare barriers to healthcare experienced by autistic adults and adults with and without other disabilities. To do so, we developed a Long- and Short-Form instrument to assess barriers in clinical and research settings. Using the Barriers to Healthcare Checklist-Long Form, we surveyed 437 participants (209 autistic, 55 non-autistic with disabilities, and 173 non-autistic without disabilities). Autistic participants selected different and greater barriers to healthcare, particularly in areas related to emotional regulation, patient-provider communication, sensory sensitivity, and healthcare navigation. Top barriers were fear or anxiety (35% (n = 74)), not being able to process information fast enough to participate in real-time discussions about healthcare (32% (n = 67)), concern about cost (30% (n = 62)), facilities causing sensory issues 30% ((n = 62)), and difficulty communicating with providers (29% (n = 61)). The Long Form instrument exhibited good content and construct validity. The items combined to create the Short Form had predominantly high levels of correlation (range 0.2-0.8, p < 0.001) and showed responsiveness to change. We recommend healthcare providers, clinics, and others working in healthcare settings to be aware of these barriers, and urge more intervention research to explore means for removing them.

Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability

BACKGROUND

We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID.

METHODS

Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health.

RESULTS

Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable.

CONCLUSIONS

Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.