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Fante C, De Luca Picione R, Dioni B, Manari T, Raffin C, Capelli F, Franceschini C, Lenzo V, Musetti A. Parental Quality of Life and Impact of Multidisciplinary Intervention for Children with Autism Spectrum Disorders: A Qualitative Study. J Autism Dev Disord 2024:10.1007/s10803-023-06225-x. [PMID: 38170430 DOI: 10.1007/s10803-023-06225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
The presence of a child with Autism Spectrum Disorder (ASD) in the family can have a negative impact on parental Quality of Life (QoL), but evidence on how treatments for children with ASD can affect parental QoL is currently limited. In this qualitative study, we develop a semi-structured interview in order to investigate the impact of ASD on the QoL of mothers and fathers from a subjective perspective, as well as the effect of the intervention on their QoL and adjustment process. The sample consisted of 31 parents of children with ASD severity 2 or 3, aged 5 to 11 years, undergoing a multidisciplinary intervention. In order to identify emerging themes from the interview transcripts, a Thematic Analysis was conducted using a bottom-up approach. We identified three main themes relating to parental QoL (ASD impact on QoL, useful external resources, QoL improvement-related factors) and five themes relating to parents' views on the intervention (positive impact on parent, dissatisfaction with previous interventions, parental involvement, useful features, critical issues). The results provide indications of the process of parental adaptation and the components of interventions that foster an improvement in their QoL. In conclusion, living with a child with ASD can have a significant influence on a parents' QoL, not just physically and emotionally, but also in terms of general goals, family structure, and social interactions.
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Affiliation(s)
- Chiara Fante
- Institute for Educational Technologies, National Research Council, Via De Marini 6, Torre di Francia, Genoa, Italy.
| | | | - Barbara Dioni
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Cinzia Raffin
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
| | | | | | - Vittorio Lenzo
- Department Educational Sciences, University of Catania, Catania, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy.
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Musetti A, Manari T, Dioni B, Raffin C, Bravo G, Mariani R, Esposito G, Dimitriou D, Plazzi G, Franceschini C, Corsano P. Parental Quality of Life and Involvement in Intervention for Children or Adolescents with Autism Spectrum Disorders: A Systematic Review. J Pers Med 2021; 11:894. [PMID: 34575671 PMCID: PMC8469292 DOI: 10.3390/jpm11090894] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Previous research has examined several parental, child-related, and contextual factors associated with parental quality of life (QoL) among parents with a child or an adolescent with autism spectrum disorders (ASD); however, no systematic review has examined the relationship between parental QoL and parental involvement in intervention. To fill this gap, a systematic review was conducted using four electronic databases and checked reference lists of retrieved studies. Records were included in the systematic review if they presented original data, assessed parental QoL, and involvement in intervention for children or adolescents with ASD, were published in peer-reviewed journals between 2000 and 2020, and were written in English. Among the 96 screened full-texts, 17 articles met the eligibility criteria. The selected studies included over 2000 parents of children or adolescents with ASD. Three categories of parental involvement (i.e., none, indirect, direct) were identified, which varied across studies, although most had direct parental involvement. The results from this review show that increased parental involvement in the intervention for children or adolescents with ASD may be one way to promote their QoL. However, further research specifically focused on parental involvement during the intervention for children and adolescents with ASD is warranted.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Barbara Dioni
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Cinzia Raffin
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Giulia Bravo
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Gianluca Esposito
- Social and Affective Neuroscience Lab, Psychology Program-SSS, Nanyang Technological University, Singapore 639818, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University Trento, 38068 Rovereto, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Department of Psychology and Human Development, UCL-Institute of Education, London WC1H 0AA, UK
- The National Institute for Stress, Anxiety, Depression and Behavioural Change (NISAD), 252 21 Helsingborg, Sweden
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- IRCCS Institute of Neurological Sciences of Bologna (ISNB), 40139 Bologna, Italy
| | | | - Paola Corsano
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders: The Optimus Co-design Project that has Made it to Regular Care. Int J Integr Care 2021; 21:3. [PMID: 33953649 PMCID: PMC8051154 DOI: 10.5334/ijic.5494] [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] [Indexed: 11/30/2022] Open
Abstract
Introduction: Multiple neurodevelopmental problems affect 7–8% of children and require evaluation by more than one profession, posing a challenge to care systems. Description: The local problem comprised distressed parents, diagnostic processes averaging 36 months and 28 visits with 42% of children >4 years at referral to adequate services, and no routines for patient involvement. The co-design project was developed through a series of workshops using standard quality improvement methodology, where representatives of all services, as well as parents participated. The resulting integrated care model comprises a team of professionals who evaluate the child during an average of 5.4 appointments (N = 95), taking 4.8 weeks. Parents were satisfied with the holistic service model and 70% of children were under 4 at referral (p < 0.05). While 75% of children were referred, 25% required further follow-up by the team. Discussion: The Optimus model has elements of vertical, clinical and service integration. Reasons for success included leadership support, buy-in from the different organisations, careful process management, a team co-ordinator, and insistent user involvement. Conclusion: Evaluating multiple neurodevelopmental problems in children requires an integrated care approach. The Optimus care model is a relevant showcase for how people-initiated integrated care reforms can make it into usual care.
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Westman Andersson G, Gillberg N, Miniscalco C. Parents of Children Diagnosed with Autism Spectrum Disorder: What Do They Expect and Experience from Preschools? Neuropsychiatr Dis Treat 2021; 17:3025-3037. [PMID: 34611403 PMCID: PMC8487270 DOI: 10.2147/ndt.s324291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In Sweden, children diagnosed with autism spectrum disorders (ASD) as well as other children in need of special support, according to the law should be provided stimulation and support for their development in their preschools. Parents of children diagnosed with ASD have been shown to struggle to ensure the right to support for their child from society, including in preschool. This study reports parent expectations and experiences when having a child diagnosed with ASD in preschool. METHODS A questionnaire with 12 open-ended and 9 multiple-choice questions was completed by parents of 26 children (3 girls, 23 boys, mean age 4:3 years). The children had been diagnosed with ASD within the last year. The data were analyzed using a qualitative inductive approach with a content analysis of the open-ended questions. FINDINGS AND CONCLUSIONS This study shows that parents expect competence and knowledge about ASD among preschool staff, including the principal. They need continuous dialogue between parents and the preschool staff and expect individualized support for their child. Concerns about their child in preschool frequently occurred.
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Affiliation(s)
- Gunilla Westman Andersson
- Department of Education and Special Education, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.,Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nanna Gillberg
- Department of Business Administration, School of Business, Economics and Law at the University of Gothenburg, Gothenburg, Sweden
| | - Carmela Miniscalco
- Neuropsychiatric Department and Pediatric Speech and Language Pathology Department, Queen Silvia Children's Hospital & Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
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Zakirova Engstrand R, Roll-Pettersson L, Westling Allodi M, Hirvikoski T. Needs of Grandparents of Preschool-Aged Children with ASD in Sweden. J Autism Dev Disord 2020; 50:1941-1957. [PMID: 30825081 PMCID: PMC7261267 DOI: 10.1007/s10803-019-03946-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Little is known about needs of grandparents of young children with autism in family and community settings. This study investigated perceived needs of grandparents of preschool-aged children diagnosed with ASD in the cultural context of Sweden. Participants were 120 grandparents of children enrolled into autism intervention programs provided by the public disability services in Stockholm. The Grandparents' Needs Survey and the SDQ Impact supplement were used to collect data. Grandparents expressed most needs in topic areas of information and childcare. No significant relations were found between grandparents' demographics and perceptions of needs; grandparents' needs were predicted by their perceived burden. The findings provide insight into understanding of grandparents' needs essential for planning and provision of quality family-centered early intervention services.
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Affiliation(s)
| | - Lise Roll-Pettersson
- Department of Special Education, Stockholm University, 106 91, Stockholm, Sweden
| | - Mara Westling Allodi
- Department of Special Education, Stockholm University, 106 91, Stockholm, Sweden
| | - Tatja Hirvikoski
- Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
- Habilitation & Health, Stockholm County Council, Stockholm, Sweden
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Parenting behavior and the development of children with autism spectrum disorder. Compr Psychiatry 2019; 90:21-29. [PMID: 30658339 DOI: 10.1016/j.comppsych.2018.11.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental disorders in which multiple genetic and environmental factors play roles. Symptoms of deficits in social communication and restrictive, repetitive behavioral patterns emerge early in a child's development. While parents do not cause these difficulties, impairments in social relatedness can strain parent child interactions and parental stress can have negative transactional effects that impede children development. Conversely, as with typically developing children, parental behavior can also enhance development in ASD and parents play a role in many interventions. In this review we examine parental contributions to the development of children with ASD, focusing on social communication and emotion regulation. We address parent and family characteristics that may impede development so they can be identified in families and interventions developed to target them.
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Nilses Å, Jingrot M, Linnsand P, Gillberg C, Nygren G. Experiences Of Immigrant Parents In Sweden Participating In A Community Assessment And Intervention Program For Preschool Children With Autism. Neuropsychiatr Dis Treat 2019; 15:3397-3410. [PMID: 31827325 PMCID: PMC6902863 DOI: 10.2147/ndt.s221908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Barriers inherent in service systems for autism can hinder parents from getting help for their children, and this is probably especially true for immigrant parents. In order to provide accessible assessment and interventions for preschool children with autism, a multidisciplinary team was established in one district of a Swedish city, with a majority population of immigrants. AIM The aim of the present study was to gain knowledge of the parents' experiences of participating in the community assessment and intervention program. METHODS AND PROCEDURES A qualitative study with semi-structured interviews was conducted with parents of 11 children aged 3-5, who had been diagnosed with autism and participated in the community intervention program for at least 1 year. The interviews were recorded and transcribed verbatim, and data were analyzed following a phenomenological hermeneutical method. RESULTS The overall meaning of the parents' narratives was interpreted as "A new way of understanding my child made life more hopeful and more challenging than before". Their experience was interpreted as a process, captured in the three main themes: "An overwhelming diagnosis", "Cooperating with the team", and "Growing as a parent". CONCLUSION As lacking knowledge of available resources and support seems to be an important barrier to access services, the results underscore the importance of providing individually tailored services including comprehensive societal support to immigrant families with young children suffering from autism. The study also highlights the importance of addressing the parents' previous awareness and knowledge of autism early in the assessment process, as well as continually involving parents in the intervention program, and this may enhance parental growth.
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Affiliation(s)
- Åsa Nilses
- Center for Progress in Children's Mental Health, Region Vastra Gotaland, Gothenburg, Sweden
| | - Marianne Jingrot
- Research and Development Primary Health Care, Region Vastra Gotaland, Gothenburg, Sweden
| | - Petra Linnsand
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Child and Adolescent Specialist Centre, Angered Hospital, Region Vastra Gotaland, Angered, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Child and Adolescent Specialist Centre, Angered Hospital, Region Vastra Gotaland, Angered, Sweden
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