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Garrido D, Catena A, Garcia-Retamero R. Neurodevelopmental disorders and family quality of life: emerging trends and future research directions. Pediatr Res 2024:10.1038/s41390-024-03350-w. [PMID: 38926550 DOI: 10.1038/s41390-024-03350-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/30/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024]
Abstract
Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we conducted a scientometric analysis to describe this literature, detect certain variables that could be related to FQoL, and identify tendencies and open questions for future research. A literature search in the Web of Science, PubMed, and Scopus was run and identified 3281 publications published between 1975 and 2022. The results suggest an increase in the quantity of publications on FQoL in ASD and ADHD over the last few years (14% and 12%, respectively). For both research fields, the USA published the highest number of documents, showing that the production related to ADHD and FQoL is concentrated in just a few countries. Thematic analysis revealed several clusters, considering quality of life and children as core themes that are still setting trend lines. Moreover, it would be worthwhile to describe and analyze FQoL not only during the childhood of children with ASD and ADHD but also during their adolescence. IMPACT: Although the relationship between family quality of life and neurodevelopmental disorders could be considered novel, there is a growing interest from an interdisciplinary perspective. Family quality of life should be monitored not only during the childhood of children with ASD and ADHD, but also during their adolescence and adulthood. The analysis of the family quality of life in first-degree relatives and its relationship with protective factors (e.g., resilience and social support) should be explored in future studies.
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Affiliation(s)
| | | | - Rocio Garcia-Retamero
- University of Granada, Granada, Spain
- Max Planck Institute for Human Development, Berlin, Germany
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Davy G, Barbaro J, Unwin K, Clark M, Jellett R, Date P, Muniandy M, Dissanayake C. Child and caregiver predictors of primary caregiver participation in families of school-aged Autistic children. Autism Res 2024. [PMID: 38783757 DOI: 10.1002/aur.3166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
Engaging in meaningful activities (e.g., leisure, spiritual, fitness) significantly affects caregivers' quality of life (QoL), yet the determinants of participation in caregivers of Autistic children remain largely unknown. The current study examined child and caregiver correlates of primary caregiver participation in meaningful activities. One hundred and six primary caregivers of Autistic children (7-12 years) were recruited from three unique cohorts of Autistic children in this cross-sectional study. Primary caregivers completed online questionnaires measuring occupational gaps (i.e., desired activities caregivers are not participating in), QoL, parenting stress, perceived family outcomes, and social support. In addition to undertaking direct assessments of children's cognition and language, primary caregivers also reported on their child's adaptive behavior, social-emotional skills, and participation. Caregivers reporting fewer occupational gaps (i.e., ≤2 desired activities) were more likely to have Autistic children with no co-occurring conditions, who were older, and with better adaptive behaviors, social-emotional skills, and more frequent home and school participation, compared to caregivers reporting many gaps (i.e., ≥3 desired activities). Caregivers with fewer occupational gaps also reported improved QoL, parenting stress, social support, perceived community inclusiveness, and family outcomes. Logistic regression analysis identified child age, child adaptive behavior, social-emotional skills, home participation, and the caregivers' perceived family outcomes and QoL as important predictors of their occupational gaps. The findings demonstrate that caregiver participation in desired activities was associated with increased functional ability and independence of the child, as well as their perceived capacity to meet their child's needs. Supporting parents' sense of efficacy in meeting their children's needs and building their skills and knowledge will serve to improve both caregiver and child outcomes.
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Affiliation(s)
- Gemma Davy
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Katy Unwin
- Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Megan Clark
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Rachel Jellett
- Department of Psychological Sciences, Swinburne University of Technology, Australia
| | - Perrin Date
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Melanie Muniandy
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
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Davy G, Barbaro J, Unwin K, Clark M, Jellett R, Date P, Muniandy M, Dissanayake C. Leisure, community, workforce participation and quality of life in primary and secondary caregivers of autistic children. Autism Res 2024; 17:799-811. [PMID: 38414177 DOI: 10.1002/aur.3113] [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: 09/01/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
Parents of Autistic children often modify their participation in leisure, social, and employment activities to meet the caregiving needs of their child. However, few studies have examined the impact this has on caregiver quality of life (QoL). The aim in the current study was to examine the role of participation in a range of activities on QoL amongst primary and secondary caregivers of school-aged Autistic children. Eighty-eight primary (93% mothers) and 63 secondary (91% fathers) caregivers of Autistic children (aged 7- to 12-years) participated in this cross-sectional study, with time pressure, participation, social support, parenting stress, and QoL measured via an online questionnaire. Compared to secondary caregivers, primary caregivers reported fewer employment hours, increased time pressure, less participation in desired activities, and higher perceived responsibility of domestic and child-rearing tasks. Similar levels of leisure frequency, parenting stress, and QoL were identified by both caregivers. Hierarchical regression revealed caregiver participation as important for QoL in both primary and secondary caregivers. However, when measures of caregiver well-being were added to the model, the unique contribution of participation to QoL was reduced, particularly for secondary caregivers. Overall, the findings demonstrate that despite differences in caregiver roles and responsibilities, participation in meaningful activities was important for QoL in all caregivers.
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Affiliation(s)
- Gemma Davy
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Katy Unwin
- Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Megan Clark
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Rachel Jellett
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Perrin Date
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Melanie Muniandy
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
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Pokoski OM, Crain H, DiGuiseppi C, Furnier SM, Moody EJ, Nadler C, Pazol K, Sanders J, Wiggins LD, Durkin MS. Economic impacts of the COVID-19 pandemic on families of children with autism and other developmental disabilities. Front Psychiatry 2024; 15:1342504. [PMID: 38419902 PMCID: PMC10899320 DOI: 10.3389/fpsyt.2024.1342504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Background To control the spread of the coronavirus disease (COVID-19), many jurisdictions throughout the world enacted public health measures that had vast socio-economic implications. In emergency situations, families of children with developmental disabilities (DDs), including autism, may experience increased difficulty accessing therapies, economic hardship, and caregiver stress, with the potential to exacerbate autism symptoms. Yet, limited research exists on the economic impacts of the COVID-19 pandemic on families of children with autism or another DD compared to families of children from the general population. Objectives To assess impact of the COVID-19 pandemic related to parental employment and economic difficulties in families of children with autism, another DD, and in the general population, considering potential modification by socioeconomic disadvantage before the pandemic and levels of child behavioral and emotional problems. Methods The Study to Explore Early Development (SEED) is a multi-site, multi-phase, case-control study of young children with autism or another DD as compared to a population comparison group (POP). During January-July 2021, a COVID-19 Impact Assessment Questionnaire was sent to eligible participants (n=1,789) who had enrolled in SEED Phase 3 from September 2017-March 2020. Parents completed a questionnaire on impacts of the pandemic in 2020 and completed the Child Behavior Checklist (CBCL) to measure behavioral and emotional health of their child during this time. Multiple logistic regression models were built for employment reduction, increased remote work, difficulty paying bills, or fear of losing their home. Covariates include group status (autism, DD, POP), household income at enrollment, child's race and ethnicity, and binary CBCL Total Problems T-score (<60 vs. ≥60). Unadjusted and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results The study included 274 children with autism, 368 children with another DD, and 385 POP children. The mean age of 6.1 years (standard deviation, 0.8) at the COVID-19 Impact Assessment did not differ between study groups. Parents of children with autism were less likely to transition to remote work (aOR [95% CI] = 0.6 [0.4, 1.0]) and more likely to report difficulty paying bills during the pandemic (1.8 [1.2, 2.9]) relative to parents of POP children. Lower income was associated with greater employment reduction, difficulty paying bills, and fear of losing their home, but inversely associated with transitioning to remote work. Parents of non-Hispanic (NH) Black children experienced greater employment reduction compared to parents of NH White children (1.9 [1.1, 3.0]). Parents from racial and ethnic minority groups were more likely to experience difficulty paying bills and fear losing their home, relative to NH White parents. Caregivers of children with CBCL scores in the clinical range were more likely to fear losing their home (2.1 [1.3, 3.4]). Conclusion These findings suggest that families of children with autism, families of lower socio-economic status, and families of racial and ethnic minority groups experienced fewer work flexibilities and greater financial distress during the pandemic. Future research can be used to assess if these impacts are sustained over time.
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Affiliation(s)
- Olivia M. Pokoski
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Hayley Crain
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Sarah M. Furnier
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Eric J. Moody
- Wyoming Institute for Disabilities, University of Wyoming, Laramie, WY, United States
| | - Cy Nadler
- Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, Kansas City, MO, United States
| | - Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jessica Sanders
- Department of Pediatrics and Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
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Gent V, Marshall J, Weir KA, Trembath D. Investigating the impact of autistic children's feeding difficulties on caregivers. Child Care Health Dev 2024; 50:e13218. [PMID: 38265139 DOI: 10.1111/cch.13218] [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: 04/21/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 01/25/2024]
Abstract
AIM The aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver-reported impact at mealtimes. BACKGROUND Caregivers of children (5-12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2-short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver-reported impact of feeding difficulties (Feeding-Swallowing Impact Survey, FS-IS). RESULTS Seventy-eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver-reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS-IS; U = 257.000, z = -4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS-IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver-reported impact with a moderate effect size (r = 0.49). CONCLUSION Autistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families.
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Affiliation(s)
| | - Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly A Weir
- The Royal Children's Hospital Parkville, Melbourne, Australia
- School of Health Sciences, The University of Melbourne, Parkville, Melbourne, Australia
- School of Health Sciences & Social Work, Griffith University, Southport, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
- CliniKids, Telethon Kids Institute, Subiaco, Australia
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Phillips B, Carpenter R. Community reintegration: Children with special healthcare needs in rural areas. J Pediatr Nurs 2023; 73:e285-e292. [PMID: 37805381 DOI: 10.1016/j.pedn.2023.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE The purpose of this study was to gather descriptions from caregivers and providers of children with special healthcare needs (CSHCN) about their experiences with community reintegration. This study focused on three community support areas: the healthcare structure, community of support, and school systems. The research question was, "How do caregivers and providers of CSHCN describe reintegration into community-based systems?" METHOD This descriptive qualitative study used focus group design to interview caregivers and providers about their experiences. Data were analyzed using conventional content analysis with open coding, clustering into categories, and abstracting into themes. RESULTS Eight themes were found within three categories. 1. Planning life and caregiving while fighting for everything needed, 2. Deciding to seek help while living with stigma, shame, and fear, 3. Coping with caregiving while feeling isolated, stressed, and overwhelmed, 4. Arranging transportation while living far away, 5. Underwhelming support in community and school systems, 6. Managing finances and covering expenses, 7. Improving communication of complex needs, and 8. Building a community, increasing confidence, and providing hope. CONCLUSION Community reintegration was described by caregivers and providers as balancing responsibilities, securing resources, and facilitating collaboration, which offer guidance for future care. IMPLICATIONS Engaging in open dialogue structured by the themes can help nurses understand the unique needs of caregivers of CSHCN. Social policy reform focused on access to care, financial resources, and school support may reduce inequities, and additional research focused on community-based systems, coping, and caregiving may identify needs based on sociodemographics and existing resources.
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Affiliation(s)
- Brad Phillips
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, WV 26506, United States of America.
| | - Roger Carpenter
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, WV 26506, United States of America
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Davy G, Barbaro J, Unwin K, Dissanayake C. Leisure, Employment, Community Participation, and Quality of Life in Primary Caregivers of Autistic Children: A Qualitative Study. J Autism Dev Disord 2023:10.1007/s10803-023-05992-x. [PMID: 37171763 PMCID: PMC10175909 DOI: 10.1007/s10803-023-05992-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE In prioritising the needs of their autistic children, parents often modify their own participation across leisure, social, and workforce activities. Few studies have examined the impact these modifications have on caregiver quality of life (QoL). The aim in the current study was to examine how parenting their autistic child/ren impacts parent's participation and QoL. METHODS Twenty primary caregivers (29-48 years, all female) of autistic children (7-11 years) were interviewed online about their participation in leisure, community, and employment activities including the impact of COVID-19. RESULTS Five themes with underlying subthemes were identified using reflexive thematic analysis. The themes were: (1) Reflecting on the important things in life, (2) Getting access to everything needed, (3) Barriers to participation in meaningful activities, (4) Facilitators of participation in meaningful activities, and (5) Participation through the COVID-19 pandemic. CONCLUSION The findings highlight the importance of regular participation in meaningful activities for parents of autistic children and the support needed by them, particularly single parents, to achieve balance between meeting caring responsibilities and their own participation needs.
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Affiliation(s)
- Gemma Davy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Katy Unwin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia.
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