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Meads J, Shepherd D, Landon J, Goedeke S. Brief Report: Investigating Temporal Factors in the Context of Parenting an Autistic Child. J Autism Dev Disord 2024; 54:2411-2417. [PMID: 35902417 DOI: 10.1007/s10803-022-05642-8] [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] [Accepted: 06/06/2022] [Indexed: 11/25/2022]
Abstract
The current study was a secondary analysis of cross-sectional data collected in New Zealand. Parents (n = 291) of an autistic child completed an online survey that included temporal/demographic questions relating to the parent and child, and parent ratings of the child's core ASD symptoms, their parenting stress, and psychological well-being. Child and parent ages were related to ASD core symptoms, parenting stress, and psychological well-being, the parent-child age gap was not. Diagnostic delay was only positively associated with parent depression and negatively associated with child communication impairment. Findings indicated that temporal variables can be predictive of parent well-being and child autism symptoms. The findings suggest that focusing interventions on communication abilities may have positive impacts parental mental health.
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Affiliation(s)
- Jake Meads
- Department of Psychology, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand
| | - Daniel Shepherd
- Department of Psychology, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand.
| | - Jason Landon
- Department of Psychology, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand
| | - Sonja Goedeke
- Department of Psychology, Auckland University of Technology, Private Bag 92006, 1142, Auckland, New Zealand
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Thevathasan N, Flood KE, Luke A, Campbell SA, Doucet S, Gander S. Caregiver's Perspectives on the Healthcare Experiences of Children With Behaviour-Related Disorders. Cureus 2022; 14:e22084. [PMID: 35308696 PMCID: PMC8920816 DOI: 10.7759/cureus.22084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: Social Pediatrics focuses on targeting and mitigating the effects of the social determinants of health on a child’s well-being and development. Negative health outcomes have been seen in children who have faced poverty, food insecurity, inadequate housing, and traumatic events. In particular, children who come from socioeconomically disadvantaged households are more likely to develop behavioural problems. The purpose of this study is to explore the experiences of caregivers for children with a behaviour-related disorder. This includes children affected by attention, academic, and social issues (e.g. attention-deficit hyperactivity disorder, autism spectrum disorder). This study will aim to understand the strengths, barriers, and social limitations to accessing and receiving care for children with behavioural disorders. Methods: A qualitative descriptive design was used to conduct three focus groups. Of the 64 caregivers contacted, a total of 13 participants agreed to be in the study. All focus groups were analyzed using inductive thematic analysis. Results: Preliminary findings suggest that caregivers value pediatricians who spend time, communicate, and make a human connection with their patients. Barriers included physician turnover, long wait times for referrals, and a lack of knowledge regarding services and programs available in their area. Three major themes emerged from this study including (1) timeliness to care, (2) advocacy, and (3) relationship building. Conclusion: Findings suggested that caregivers valued pediatricians who spend time to make a human connection with their patients. Barriers included physician turnover, long wait times for referrals, and a lack of knowledge of available services. Caregivers who were young mothers felt an added layer of judgement when accessing the necessary care for their children. This study is important as it contributes to our knowledge on the role Social Pediatrics can play in the care of children with behaviour-related disorders.
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Aranki J, Wright P, Pompa-Craven P, Lotfizadeh AD. Acceptance of Telehealth Therapy to Replace In-Person Therapy for Autism Treatment During COVID-19 Pandemic: An Assessment of Patient Variables. Telemed J E Health 2022; 28:1342-1349. [PMID: 35119331 DOI: 10.1089/tmj.2021.0397] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Importance: Children with autism achieve improved behavioral outcomes with applied behavior analytic (ABA) interventions. Typically, ABA is delivered in a participant's home or in a clinic setting. At the onset of COVID-19, treatment in these environments was not available due to health exposure concerns. A large social service organization in California rapidly pivoted to the delivery of ABA intervention through telehealth. Access disparity for telehealth has been a historical concern in health care delivery, particularly for disenfranchised populations within the autistic participant population. Objective: This study evaluated the demographic and behavioral variables associated with the acceptance or declination of telehealth by the pediatric participants' caregivers at the onset of the pandemic. Design, Setting, Participants: A non-experimental design was used, and archival data were compared for a random sample of 100 participants with autism who accepted telehealth interventions with 100 participants who declined it. Main Outcomes and Measures: Socioeconomic data, gender, age, ethnicity, language, and household size were compared. Clinical data were compared for treatment dosage, standardized Vineland Adaptive Behavior Scales scores, and Verbal Behavior Milestones Assessment and Placement Program scores. Results: None of the demographic variables were statistically significant in a participant's acceptance or declination of telehealth, but there were moderate differences in treatment dosage across the groups. Conclusions: It is concerning that a large portion of participants initially declined intervention via telehealth, resulting in these participants experiencing a gap in intervention during the pandemic. As intervention is imperative for pediatric autism participants, it is untenable that ∼40% of the population initially declined telehealth at the start of the pandemic.
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Affiliation(s)
- Jenna Aranki
- Autism Services Division, Easterseals Southern California, Irvine, California, USA
| | | | - Paula Pompa-Craven
- Autism Services Division, Easterseals Southern California, Irvine, California, USA
| | - Amin D Lotfizadeh
- Autism Services Division, Easterseals Southern California, Irvine, California, USA
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Feng Y, Zhou X, Liu Q, Deng T, Qin X, Chen B, Zhang L. Symptom severity and posttraumatic growth in parents of children with autism spectrum disorder: The moderating role of social support. Autism Res 2022; 15:602-613. [PMID: 35048558 DOI: 10.1002/aur.2673] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 11/07/2022]
Abstract
Parents of children with autism spectrum disorder (ASD) experience posttraumatic growth (PTG). No study has investigated the moderating effect of social support and family function between symptom severity and PTG. The study aims to examine whether social support and family function moderate the relationship between symptom severity and PTG among parents of children with ASD. Using a cross-sectional design, a total of 385 parents of children with ASD were recruited from September 2019 to November 2020 by convenience sampling. Participants completed the Posttraumatic Growth Inventory, Social Support Rating Scale, Autism Behavior Checklist, and Family Apgar Index. Both social support (r = 0.354, p < 0.01) and family function (r = 0.379, p < 0.05) were significantly related to PTG. Although symptom severity was not significantly related to PTG (p > 0.05), social support moderated the correlation between symptom severity and PTG [β(SE) = -0.134 (0.719), p < 0.01, 95% CI = (-3.552, -0.723)]; the positive association was stronger for low social support [β(SE) = 0.145 (0.054), t = 2.675, p < 0.01, 95% CI = (0.038, 0.252)], while the negative association was weaker for high social support [β(SE) = -0.121 (0.051), t = -2.378, p < 0.05, 95% CI = (-0.221, -0.021)]. Family function did not moderate the relationship (p > 0.05). Higher social support appears to buffer the detrimental effect of symptom severity on PTG, and social support seems to be an important factor when delivering interventions aimed at decreasing symptom severity and improving positive growth. LAY SUMMARY: Both social support and family function were positively associated with PTG. Providing sufficient perceived social support and enhancing family function promoted parents' positive psychological experience. Higher social support seemed to buffer the detrimental effect of symptom severity on PTG, and it could be an important intervention target for improving the psychological growth of parents of children with ASD.
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Affiliation(s)
- Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xuezhen Zhou
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qian Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tao Deng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xiuqun Qin
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Biyuan Chen
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Dembo RS, Huntington N, Mitra M, Rudolph AE, Lachman ME, Mailick MR. Social network typology and health among parents of children with developmental disabilities: Results from a national study of midlife adults. Soc Sci Med 2022; 292:114623. [PMID: 34891030 PMCID: PMC8748422 DOI: 10.1016/j.socscimed.2021.114623] [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: 05/28/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE There is increasing interest in the role of contextual factors in promoting well-being among parents of children with developmental disabilities. This study aimed to examine whether social network types moderate the impacts of having a child with a developmental disability on parents' health. METHODS Using cross-sectional data from the Midlife in the United States survey (MIDUS 2 and Refresher cohorts), we analyzed a sample of 363 parents of children with developmental disabilities and 4,919 parents of children without developmental disabilities. K-means cluster analysis was implemented to identify a social network typology. Modified Poisson and negative binomial regression models estimated the effect of having a child with a developmental disability and the typology on parents' physical health (self-rated health, number of chronic conditions) and mental health (self-rated mental health, major depression). RESULTS The cluster analysis revealed two social network types. Parents of children with developmental disabilities were more likely to have "restricted/unsupported" networks, whereas parents in the comparison group were more likely to have "diverse/supported" networks. Social support was more important for differentiating the network types of parents of children with developmental disabilities, while social integration was more salient for the comparison group. Parents of children with developmental disabilities fared worse on all outcomes relative to parents of children without disabilities. However, the typology had a compensatory psychological effect; the diverse/supported network type conferred greater mental health benefits to parents of children with developmental disabilities than to those in the comparison group. The diverse/supported network type was also associated with better physical health, but the associations did not differ between the two parent groups. CONCLUSIONS The results of this study emphasize the importance of social determinants of well-being for those with exceptional parenting responsibilities. Strengthening social networks may have a particularly positive impact on such parents' mental health.
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Affiliation(s)
- Robert S Dembo
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA.
| | - Nick Huntington
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 S. Street, Waltham, MA, 02453, USA.
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 S. Street, Waltham, MA, 02453, USA.
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, 1301 Cecil B. Moore Ave., Philadelphia, PA, 19122, USA.
| | - Margie E Lachman
- Department of Psychology, Brandeis University, 415 S. Street, Waltham, MA, 02453, USA.
| | - Marsha R Mailick
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave., Madison, WI, 53705, USA.
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Shepherd D, Landon J, Goedeke S, Meads J. Stress and distress in New Zealand parents caring for a child with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103875. [PMID: 33549933 DOI: 10.1016/j.ridd.2021.103875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
The aim of this cross-sectional study was to identify predictors of the mental health of parents of a child with autism spectrum disorder (ASD). A convenience sample of 658 parents residing in New Zealand completed an online questionnaire. Participants responded to questions probing parent and child characteristics, child ASD severity (the Autism Impact Measure: AIM), parenting stress (the Autism Parenting Stress Index: APSI), and parent mental health (the General Health Questionnaire: GHQ-28). The results indicated that the majority of the parents in our sample have reached clinical levels of psychiatric distress, in particular anxiety. Parent and child characteristics were poor predictors of parental mental health problems. Parenting stress, however, was found to be a significant predictor, also acting as a mediator variable between child ASD symptom severity and parental mental health problems. Our findings are interpreted in relation to their significance to clinical practice.
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Affiliation(s)
- Daniel Shepherd
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand.
| | - Jason Landon
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Sonja Goedeke
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
| | - Jake Meads
- Department of Psychology, Auckland University of Technology, Auckland, New Zealand
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McAuliffe T, Cordier R, Chen YW, Vaz S, Thomas Y, Falkmer T. In-the-moment experiences of mothers of children with autism spectrum disorder: a comparison by household status and region of residence. Disabil Rehabil 2020; 44:558-572. [PMID: 32552117 DOI: 10.1080/09638288.2020.1772890] [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: 10/24/2022]
Abstract
Purpose: This study compared the in-the-moment experiences among mothers of children with Autism Spectrum Disorders (ASD) by their household status (i.e., single versus coupled) and region of residence (i.e., regional versus major city area).Methods: An experience sampling method was employed to collect data, and a total of 40 mothers used an iOS device to record activity types and in-the-moment experiences for one week during school term. Mann-Whitney U test and multilevel analysis were conducted to compare the experiences of these mothers.Results: The analyses found the following results: 1) mothers spent most time in childcare and least time in self-care activities; 2) coupled mothers were more likely to feel supported; 3) coupled mothers were less likely to feel supported in domestic tasks; 4) mothers from major city were more likely to feel challenged in self-care activities; and 5) mothers from major city were more likely to feel supported in productivity tasks.Conclusion: Limited but significant differences between single and coupled mothers, as well as mothers from regional and major city areas, were found. Future research direction and service provisions were suggested.Implications for rehabilitationThis study shows that all mothers spent the most time on childcare and the least amount of time on self-care activities.In-the-moment experiences between single and coupled mothers, as well as mothers from major cities and mothers from regional areas, differ somewhat; however, this study builds evidence to support that these mothers' experiences are similar.The result of the study indicates that single mothers require extra support as they carry similar levels of responsibilities as coupled mothers, but without the support of a partner.Promoting a sense of control may assist all mothers to fully engage in parenting activities.
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Affiliation(s)
- Tomomi McAuliffe
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Department of Social Work, Education and Community Wellbeing, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Yu-Wei Chen
- Discipline of Occupational Therapy, Faculty of Health Sciences, The University of Sydney, Lindcombe, NSW, Australia
| | - Sharmila Vaz
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Yvonne Thomas
- Allied Health and Social Sciences, Institute of Health and Society, University of Worcester, Worcester, UK
| | - Torbjörn Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Pain and Rehabilitation Centre, Department of Medical Sciences, Linkoping University, Linkoping, Sweden
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Yusuf A, Peltekova I, Savion-Lemieux T, Frei J, Bruno R, Joober R, Howe J, Scherer SW, Elsabbagh M. Perceived utility of biological testing for autism spectrum disorder is associated with child and family functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 100:103605. [PMID: 32120048 DOI: 10.1016/j.ridd.2020.103605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The clinical integration of chromosomal microarray testing promises improvements in diagnostic yields in Autism Spectrum Disorder (ASD). While the impact on clinical management is promising for some families, the utility perceived by families, including the majority for whom results are negative, is unclear. With next generation genomic sequencing technologies poised for integration, along with promising ASD biomarkers being developed, there is a need to understand the extent to which genomic and other biological testing would have utility for the target recipients of these tests and their families. The purpose of the present cross-sectional study was to examine the predictors of perceived utility of biological testing among parents of a child with ASD. METHODS The Perceived Utility of Biotesting (PUB) Questionnaire was developed based on literature review and integrating family review. Following their child's diagnosis, families participating in an ongoing prospective study completed the PUB questionnaire along with self-reported measures of parent stress, child and family functioning, and family-centered care prior to undergoing genetic testing for both clinical and research purposes. RESULTS Based on n = 85 families, psychometric properties of the Perceived Utility of Biotesting questionnaire suggest a reliable and valid instrument. A stepwise regression analysis reveals that lower levels of child emotional and behavioural functioning and higher levels of family functioning correlated with higher perceived utility for biological testing. LIMITATIONS A main limitation in the study is the participation rate of 50 %, thus the possibility of self-selection bias cannot be ruled out. We also chose to assess perceived utility among parents rather than the individuals with ASD themselves: modifying the questionnaire to capture perceived utility from autistic individuals across the lifespan would prove essential in future studies. Finally, ongoing validation of the PUB by assessing the PUB's discriminant and convergent validity is still needed. CONCLUSIONS We conclude that the utility of biological testing perceived by families whose child is undergoing genetic testing around ASD diagnosis depends on their unique child and family characteristics. This signifies that engaging families in biomarker discovery for improving the impact of research and care requires systematic input from a representative sample of families.
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Affiliation(s)
- Afiqah Yusuf
- Azrieli Centre for Autism Research, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Iskra Peltekova
- Azrieli Centre for Autism Research, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Tal Savion-Lemieux
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Jennifer Frei
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Ruth Bruno
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Montreal, Canada
| | - Jennifer Howe
- The Centre for Applied Genomics, Hospital for Sick Children, Toronto, Canada
| | - Stephen W Scherer
- The Centre for Applied Genomics, Hospital for Sick Children, Toronto, Canada; McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Canada
| | - Mayada Elsabbagh
- Azrieli Centre for Autism Research, Montreal Neurological Institute-Hospital, McGill University, Montreal, Canada; Research Institute of the McGill University Health Centre, Montreal, Canada.
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Documenting and Understanding Parent's Intervention Choices for Their Child with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:988-1001. [PMID: 29214603 DOI: 10.1007/s10803-017-3395-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Understanding why parents choose some interventions but not others for their child with autism is important for a number of reasons. Estimating the proportion of evidence-based interventions engaged, identifying the agencies influencing parental decisions, and elucidating the barriers or reasons leading to intervention rejection or discontinuation can result in better service provision. New Zealand parents (n = 570) of a child with autism reported what interventions were being engaged, and why some interventions were engaged but not others. Funding was a major determinant of intervention engagement, while medical professionals exerted the most influence. Sources of support were not related to intervention engagement, but parental perceptions of their child's symptom severity were. Finally, non-engagement does not necessarily reflect parental opposition to an intervention, but rather the existence of barriers.
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Parenting an Adult with High-Functioning Autism Spectrum Disorder. AUTISM IN ADULTHOOD 2019. [DOI: 10.1007/978-3-030-28833-4_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shepherd D, Csako R, Landon J, Goedeke S, Ty K. Brief Report: Parent’s Assessments of Their Care-Related Stress and Child’s ASD Symptoms in Relation to Their child’s Intervention History. J Autism Dev Disord 2018; 48:2879-2885. [DOI: 10.1007/s10803-018-3543-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Shepherd D, Landon J, Taylor S, Goedeke S. Coping and care-related stress in parents of a child with autism spectrum disorder. ANXIETY STRESS AND COPING 2018; 31:277-290. [DOI: 10.1080/10615806.2018.1442614] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Daniel Shepherd
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Jason Landon
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Steve Taylor
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
| | - Sonja Goedeke
- School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand
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Landon J, Shepherd D, Goedeke S. Predictors of Satisfaction with Life in Parents of Children with Autism Spectrum Disorder. J Autism Dev Disord 2017; 48:1640-1650. [DOI: 10.1007/s10803-017-3423-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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