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Herrero R, Díaz A, Zueco J. The Burden and Psychological Distress of Family Caregivers of Individuals with Autism Spectrum Disorder: A Gender Approach. J Clin Med 2024; 13:2861. [PMID: 38792402 PMCID: PMC11121944 DOI: 10.3390/jcm13102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: Relatives play the main role as caregivers of autism spectrum disorder (ASD) individuals. Women, specifically mothers, are the majority of caregivers of ASD relatives. In addition, the literature on caregivers has shown that women have worse mental health and higher perceived burdens than men. Therefore, the aim of this work was to evaluate the relationships between psychological distress and burden using a gender approach in caregivers of ASD relatives. Methods: A cross-sectional design was applied in this study with a convenience sample of 250 caregivers of ASD relatives. Most of them were mothers caring for a child who ranged in age from 1 to 31 years. Sociodemographic variables considered were age, education level, marital status, and relation to the care recipient. Additionally, psychological distress and objective burden, in the form of hours/day caring, and subjective burden, in the form of perceived burden, were analyzed. Results: Significant gender differences were found in psychological distress and objective and subjective burden, with women showing higher scores than men. Both types of burden played a serial mediating role between gender and psychological distress. Conclusions: The results highlight the important role of gender, with women bearing the high cost of caring for their children with ASD in the form of high objective burden, caring for more hours, and subjective burden, perceiving more burden and showing poorer mental health than men. These results show the need for specific support and intervention programs targeted to women caregivers to reduce burden and improve their mental health.
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Affiliation(s)
- Raquel Herrero
- Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (R.H.); (A.D.)
| | - Amelia Díaz
- Faculty of Psychology, University of Valencia, 46010 Valencia, Spain; (R.H.); (A.D.)
| | - Jesús Zueco
- Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain
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Lee J, Barger B. Factors Predicting Poor Mental and Physical Health in Parents of Children with Autism Spectrum Disorder: Results from 2016 to 2019 National Survey of Children's Health. J Autism Dev Disord 2024; 54:915-930. [PMID: 36562931 DOI: 10.1007/s10803-022-05870-y] [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: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Although poor health has been reported in parents of children with autism spectrum disorder (ASD), most studies excluded fathers and focused on mental health. We combined 2016-2019 data from the National Surveys of Children's Health to determine child and parent characteristics that predict poor mental and physical health in fathers (n = 818) and mothers (n = 2111) of children with ASD. For fathers of children with ASD, higher parenting stress was significantly associated with greater odds of poor physical health, whereas racial and ethnic minorities and living at 400% above the federal poverty were significantly associated with lower odds of poor mental health. For mothers of children with ASD, greater child sleep problems were significantly associated with greater odds of poor physical health, and two-parent household living 400% above the poverty line was significantly associated with reported lower odds of poor mental health. Continued efforts to reduce parenting stress and improve child sleep problems, along with expanding existing services and coverages of ASD services, especially for low-income families, may help reduce the burden on these families, preventing adverse future health outcomes in this population.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Suite 911, Atlanta, GA, 30303, USA.
| | - Brian Barger
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Işık-Uslu AE, Çetin Z. Early intervention service needs of mothers with a child diagnosed with autism spectrum disorder in Turkey: A qualitative study. J Pediatr Nurs 2024; 75:e159-e168. [PMID: 38199934 DOI: 10.1016/j.pedn.2024.01.007] [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: 08/29/2023] [Revised: 01/06/2024] [Accepted: 01/06/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Early intervention services play a crucial role in the prevention and management of Autism Spectrum Disorder (ASD). With the increasing prevalence of ASD, understanding the specific needs of mothers and their children is essential for the development of effective interventions and support systems. METHODS This interview study examines the early intervention service needs of Turkish mothers with children aged 2-6 who have been diagnosed with ASD. Semi-structured in-depth interviews were conducted with nine mothers. Thematic analysis was carried out following the guidance and six steps procedures described by Braun and Clarke. FINDINGS The study's findings reveal six distinct themes that encompass the needs expressed by the participating mothers: 1) psychological support needs, 2) social support needs, 3) financial support needs, 4) strengthening the family, 5) government-based enhancement, and 6) the need for social awareness. DISCUSSION The findings underscore the significance of comprehensive early intervention services tailored to address the needs of mothers. The stressors associated with the impact of ASD on families are highlighted, aligning with Guralnick's framework. The findings emphasize the need for holistic intervention programs and stress the importance of collaborative relationships among parents, educators, and service providers. APPLICATION TO PRACTICE The practical implications of this study benefit healthcare professionals, policymakers, educators, and stakeholders. The emphasis lies in aligning interventions with the ASD needs of both mothers and children, ultimately aiding in the development of effective policies and the enhancement of the quality of care for individuals with ASD in Turkey.
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Affiliation(s)
- A Elif Işık-Uslu
- Research assistant, Department of Child Development, Faculty of Health Sciences, Hacettepe University, Turkey.
| | - Zeynep Çetin
- Professor, Department of Child Development, Faculty of Health Sciences, Hacettepe University, Turkey
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4
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Volgyesi-Molnar M, Gyori M, Eapen V, Borsos Z, Havasi A, Jakab Z, Janoch L, Nemeth V, Oszi T, Szekeres A, Stefanik K. Quality of Life in Hungarian Parents of Autistic Individuals. J Autism Dev Disord 2024:10.1007/s10803-024-06243-3. [PMID: 38280137 DOI: 10.1007/s10803-024-06243-3] [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: 01/08/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE Parents of autistic individuals have been known to have a lower overall quality of life (QQL) than those of typically developing children. We present the first Hungarian large-sample study whose objective was to explore the differences in QOL between parents of autistic individuals (AS) and those of neurotypical (NT) persons. METHODS Based on the ABCX model we developed a questionnaire comprising standardized scales to characterize the life of parents involved. Our data came from parents of 842 individuals (ASD = 521, NT = 321) between 0 and 49 years. Battery deployed standardized instruments to examine quality of life (WHO-QQL BREF and Quality of Life in Autism questionnaire, QOLA). We assessed the families' socio-economic/demographic characteristics, parents' psychological well-being, the autistic/neurotypical individuals' characteristics, and the interventions. RESULTS Our data showed significantly lower QOL in parents of autistic individuals in all domains of questionnaires. We analyzed 20 relevant factors to uncover the predictors of parental QOL. We confirmed the existence of most but not all predictors present in earlier literature and identified intervention-related predictors. CONCLUSION Our study confirms the importance of supporting parents in their role, and of providing health and social supports that focus on quality of life, in addition to child care.
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Affiliation(s)
- Marta Volgyesi-Molnar
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary.
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary.
| | - Miklos Gyori
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District & Ingham Institute, Liverpool, Australia
| | - Zsofia Borsos
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute for the Psychology of Special Needs, ELTE University, Budapest, Hungary
| | - Agnes Havasi
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Zoltan Jakab
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute for the Psychology of Special Needs, ELTE University, Budapest, Hungary
| | - Laszlone Janoch
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Vivien Nemeth
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
- Faculty of Education and Psychology, Doctoral School of Education, ELTE University, Budapest, Hungary
| | - Tamasne Oszi
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Agota Szekeres
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
- Hungarian University of Agriculture and Life Sciences, Institute of Education, Kaposvar, Hungary
| | - Krisztina Stefanik
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
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Katti H, Valiyamattam G, Taubert J, Nadig A. Editorial: Improving the quality of life of autistic people and their caregivers from diverse backgrounds: methods and approaches. Front Psychol 2023; 14:1242236. [PMID: 38022950 PMCID: PMC10680255 DOI: 10.3389/fpsyg.2023.1242236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Harish Katti
- National Institute of Mental Health, Bethesda, MD, United States
| | | | - Jessica Taubert
- The School of Psychology, The University of Queensland, St. Lucia, QLD, Australia
| | - Aparna Nadig
- School of Communication Sciences and Disorders, McGill University, Montreal, QC, Canada
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Christi RA, Roy D, Heung R, Flake E. Impact of Respite Care Services Availability on Stress, Anxiety and Depression in Military Parents who have a Child on the Autism Spectrum. J Autism Dev Disord 2023; 53:4336-4350. [PMID: 36030352 PMCID: PMC9419919 DOI: 10.1007/s10803-022-05704-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Parenting an autistic child can affect a family's well-being. Finding resources is critical. This pilot study looked at respite's impact on parental stress, anxiety, and depression in military families and demographic factors associated with presence of respite care. METHOD Participants completed three surveys on anonymous basis, including two standardized surveys measuring parental stress and anxiety/depression. Data analysis used Chi-square test and regression analysis. RESULTS Parents receiving respite reported less stress and anxiety/depression. Respite utilization was associated with absence of comorbid conditions in child and other variables. Predictor variables for parental stress and anxiety/depression included presence of comorbid conditions in child. CONCLUSION Respite care may be linked to lower parental stress, anxiety, and depression, but more study is needed.
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Affiliation(s)
- Rebecca A Christi
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, 98431, MC, WA, Washington, United States.
| | - Daniel Roy
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, 98431, MC, WA, Washington, United States
| | - Raywin Heung
- Department of Clinical Investigation, Madigan Army Medical Center, Joint Base Lewis-McChord, Washington, United States
| | - Eric Flake
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Madigan Army Medical Center, Joint Base Lewis-McChord, 98431, MC, WA, Washington, United States
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Tinelli M, Roddy A, Knapp M, Arango C, Mendez MA, Cusack J, Murphy D, Canitano R, Oakley B, Quoidbach V. Economic analysis of early intervention for autistic children: findings from four case studies in England, Ireland, Italy, and Spain. Eur Psychiatry 2023; 66:e76. [PMID: 37732502 PMCID: PMC10594363 DOI: 10.1192/j.eurpsy.2023.2449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13 months did not support its cost-effectiveness. We modeled cost-effectiveness over 6 years and across four European countries. METHODS Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6 years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study. RESULTS PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13 months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6 years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment. DISCUSSION PACT may be recommended as a cost-saving early intervention for families with an autistic child.
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Affiliation(s)
- Michela Tinelli
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Aine Roddy
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Atlantic Technological University, Sligo, Ireland
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Maria Andreina Mendez
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | | | | | - Roberto Canitano
- University Hospital of Siena – Azienda ospedaliero-universitaria Senese, Siena, Italy
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Mazzoni N, Bentenuto A, Filosofi F, Tardivo A, Strathearn L, Zarei K, De Falco S, Venuti P, Iandolo G, Giannotti M. Parenting a Child with a Neurodevelopmental Disorder during the Early Stage of the COVID-19 Pandemic: Quantitative and Qualitative Cross-Cultural Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:499. [PMID: 36612822 PMCID: PMC9819011 DOI: 10.3390/ijerph20010499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Research during the COVID-19 pandemic has shown a strong relationship between child symptoms, parental stress, and mental health challenges. The pandemic has changed family routines, worsening child symptomatology and parental burden. The aim of this study was to investigate how the magnitude of the perceived changes in child externalizing behavior, parental stress, and discontinuity of therapy-from before to during the COVID-19 pandemic-affected parental mental health during the pandemic. Moreover, we sought to compare these aspects cross-culturally between European countries and the USA. To these purposes, we asked Italian, Spanish, and U.S. parents of children with neurodevelopmental disabilities (NDD) to complete an online survey. Quantitative results showed that increased parental stress may have contributed to a worsening in parental psychological distress, regardless of culture. Moreover, they suggested an indirect effect of child externalizing behaviors on parents' psychological distress via parental stress. Qualitative analyses highlighted that the lack, or discontinuity, of therapeutic activities may have been one of the key contributors to parenting burden during the COVID-19 pandemic. Finally, qualitative results highlighted resilience factors that could have decreased the risk of psychological problems during the pandemic, such as a strong sense of parental efficacy and the ability to adapt to changing family dynamics.
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Affiliation(s)
- Noemi Mazzoni
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
| | - Arianna Bentenuto
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
| | - Fabio Filosofi
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
| | - Angela Tardivo
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
- Observation and Functional Diagnosis Division, PSISE Clinical and Developmental Psychological Service, Calle Albendiego 7, 28029 Madrid, Spain
| | - Lane Strathearn
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City, IA 52242, USA
- Hawkeye Intellectual and Developmental Disabilities Research Center (Hawk-IDDRC), University of Iowa, Iowa City, IA 52242, USA
| | - Kasra Zarei
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City, IA 52242, USA
| | - Simona De Falco
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
| | - Paola Venuti
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
| | - Giuseppe Iandolo
- Observation and Functional Diagnosis Division, PSISE Clinical and Developmental Psychological Service, Calle Albendiego 7, 28029 Madrid, Spain
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Calle Tajo S/N, (Urb. El Bosque), Villaviciosa de Odón (Madrid), 28670 Madrid, Spain
| | - Michele Giannotti
- Laboratory of Observation, Diagnosis and Educational (ODFLAB), Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Trento, Italy
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Hamama L. Modeling linkages between self-efficacy, normalization, and well-being factors among Israeli mothers of children with neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 128:104295. [PMID: 35777249 DOI: 10.1016/j.ridd.2022.104295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/16/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS Parents' well-being may be challenged by the neurodevelopmental disorders (NDs) of their children. This study explored general self-efficacy (personal resource) and normalization (coping strategy) and their possible association with mothers' well-being (satisfaction with life/SWL, positive affect, and presence of meaning in life/P-MIL). METHOD Data were obtained from 127 Israeli mothers, ages 23-63, of children (M = 12.08, SD = 3.39) with NDs (autism spectrum disorder, intellectual disability, cerebral palsy). All participants completed online self-report questionnaires. RESULTS After controlling for the effects of group, mother's age, and child's gender, bivariate associations showed that general self-efficacy was positively correlated with SWL (r =.46, p <.001), positive affect (r =.43, p <.001), and P-MIL (r =.37, p <.001). The study's mediation model was partly supported: General self-efficacy was related to normalization, which was related to SWL and positive affect, but not to P-MIL. CONCLUSIONS AND IMPLICATIONS This study contributes to the empirical knowledge on well-being in mothers raising children with NDs. Findings revealed that mothers' general self-efficacy alongside their strategy to adopt normalcy substantially contributed to their well-being. Hence, psychosocial services should strengthen general self-efficacy in this cohort and support their normalization efforts.
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Affiliation(s)
- L Hamama
- The Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv 69978, Israel.
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10
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Lake JK, Volpe T, St. John L, Thakur A, Steel L, Baskin A, Durbin A, Chacra MA, Lunsky Y. Mental health and COVID-19: The impact of a virtual course for family caregivers of adults with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:677-689. [PMID: 35915874 PMCID: PMC9539047 DOI: 10.1111/jir.12965] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/06/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted family caregivers of adults with intellectual and developmental disabilities (IDD). This study evaluated a virtual course for family caregivers from across Canada, focused on supporting the mental health and well-being of adults with IDD and their families. The evaluation examined the feasibility and acceptability of the course, as well as the impact of the intervention on participants' overall health and well-being. METHODS The 6-week virtual course, informed by a parallel Extension for Community Healthcare Outcomes (ECHO) course for service providers, combined didactic instruction with applied activities. A total of 126 family caregiver course participants consented to be part of the research evaluation delivered over three cycles between October 2020 and April 2021. Attendance was measured at each weekly session. Satisfaction was assessed weekly and post-program. Learning, self-efficacy, and well-being were assessed pre- and post-course, and again at follow-up (8 weeks post-course). Mixed-effects models assessed changes between and within individuals across time. RESULTS Participants had consistent attendance, low-dropout rates, and reported high satisfaction, with 93% of participants reporting that their expectations for the course were met. Compared with pre-course, participants reported improved self-efficacy and well-being post-course, which were maintained at follow-up. CONCLUSIONS An interactive and applied virtual education course delivered to a large group of family caregivers of adults with IDD was both feasible and acceptable. It positively impacted participants' well-being by offering much needed mental health support and creating a peer-led community of practice.
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Affiliation(s)
- J. K. Lake
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
| | - T. Volpe
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - L. St. John
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Thakur
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
- Surrey PlaceTorontoCanada
| | - L. Steel
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Baskin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - A. Durbin
- Li Ka Shing Knowledge Institute, St. Michael's HospitalTorontoCanada
| | - M. A. Chacra
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
| | - Y. Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
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Green J, Leadbitter K, Ainsworth J, Bucci S. An integrated early care pathway for autism. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:335-344. [PMID: 35303486 DOI: 10.1016/s2352-4642(22)00037-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 01/17/2023]
Abstract
In this Viewpoint, we argue for the need to reconceptualise an integrated early-care provision for autistic children in the light of their enduring support needs and relevant new findings from developmental and intervention research. This model goes beyond short-term reactive care to outline an early proactive, evidenced, developmentally phased, and scalable programme of support for autistic children and their families from the earliest opportunity, with timely access to later step-up care when needed. We also integrate this model with emerging opportunities from data science and digital health technologies as a potential facilitator of such a pathway. Building on this work, we argue that the best current autism intervention evidence can be integrated with concepts and evidence gained in the management of other enduring health conditions to support an autistic child and their family through their early development. The aim is to improve those children's social communication abilities, expand their range and flexibility of interests, and mitigate any negative impacts of sensory difficulties and restricted, repetitive behaviours on the child and their family wellbeing. The pathway solutions described could also be adapted for older adolescents and adults and could be used within the health systems of different countries, including within low-income and middle-income contexts.
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Affiliation(s)
- Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester, UK; Department of Child and Adolescent Mental Health, Manchester Royal Children's Hospital, Manchester, UK.
| | - Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester, UK
| | - John Ainsworth
- Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Robinson A, Yong E. Emotion transformation: a grounded theory for uncovering painful triggers and repairing relational connection for parents of autistic children. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-12-2020-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
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.
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13
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Wang C. Mental health and social support of caregivers of children and adolescents with ASD and other developmental disorders during COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100242. [PMID: 34580666 PMCID: PMC8457638 DOI: 10.1016/j.jadr.2021.100242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/27/2022] Open
Abstract
Background Previous studies showed that caregivers of children with autism spectrum disorder (ASD) and other developmental disorders had higher levels of parenting stress, anxiety and depression. In the present study, the author examined the caregivers' mental health and investigated the mediating role of social support between symptoms severity and parenting stress during COVID-19. Methods During 20 March to 8 April 2020, 1932 caregivers of children and adolescents with ASD and other developmental disorders from China were enrolled to fill in a sociodemographic questionnaire, Depression, Anxiety and Stress Scale and Social Support Rating Scale. The author also collected children's disability severity symptoms and behavioral problems. Results The results showed that 46.01% of the caregivers reported symptoms of depression, 44.67% showed anxiety and 44.62% showed stress during COVID-19 pandemic. Fathers were found to get more subjective support than mothers (P < 0.05). Caregivers who had the highest educational attainment had the most social support (P = 0.01). People who had the more household income showed the significantly lower levels of depression and anxiety (P < 0.05). The caregivers' employment status during COVID-19 was found significantly related with their depression, anxiety, stress and social support (P < 0.05). Limitations This study has some limitations, such as it did not conduct the longitudinal analysis of variables before COVID-19. Conclusions The findings showed that many caregivers experienced mental health problems during COVID-19. The author suggested to promote caregivers' engagement in functional social support and the behavioral interventions for their children to reduce the impact of stress, anxiety and depression.
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Affiliation(s)
- Chongying Wang
- Department of Social Psychology, Zhou Enlai School of Government, Nankai University, Tianjin, China
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14
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Holingue C, Jang Y, Azad G, Landa R. Key stakeholder perspectives on obstacles to an autism-specific Medicaid waiver service delivery model. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:205-216. [PMID: 34558157 DOI: 10.1111/jar.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children and youth with autism spectrum disorder have significant, multi-system needs that require supports, such as the autism waiver (AW) service delivery model. This study aimed to identify and describe characteristics of the AW, define obstacles and strengths in the provision of adequate services and provide recommendations for improving overall effectiveness. METHODS This mixed-methods exploratory study used an electronic survey to gain information and perceptions of AW provider agency directors (n = 27) and service coordinators (n = 30). RESULTS The key barriers reported were the shortage of qualified staff, inadequate staff training, complexity of cases or symptom severity of clients and lack of communication at multiple levels throughout the agency as well as with parents. CONCLUSIONS Recommendations include reinforcing the workforce through higher salaries, greater training and communication interventions. These strategies may reduce staff turnover and shortage, lighten the caseload, reduce the waitlist period and improve the effectiveness and responsiveness of AW services.
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Affiliation(s)
- Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yeon Jang
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Gazi Azad
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, New York, New York, USA.,Center for Autism and the Developing Brain, Weill Cornell Medicine, New York State Psychiatric Institute, New York, New York, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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15
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Sonido MT, Hwang YI, Srasuebkul P, Trollor JN, Arnold SRC. Predictors of the Quality of Life of Informal Carers of Adults on the Autism Spectrum. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [PMID: 34254220 DOI: 10.1007/s40489-019-00177-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Carers of adults on the autism spectrum often experience high levels of stress, worry, and caregiver burden. There are few studies identifying the predictors of carer mental well-being and none have been conducted in Australia. Data from the Autism Cooperative Research Centre for Living with Autism's Australian Longitudinal Study of Autism in Adulthood was used to test the conceptual model by Sonido et al. (Rev J Autism Dev Disord, 2019, https://doi.org/10.1007/s40489-019-00177-8 ) by (a) identifying the predictors of mental well-being for carers of adults on the spectrum, (b) using model selection to determine which predictors contribute to the model of best fit, and (c) testing for mediating relationships between the predictors. Several predictors were directly associated with carer psychological quality of life, including carer age, care recipient intellectual disability, and carer intolerance of uncertainty. Model selection strongly supported the inclusion of most clusters from the conceptual model. Some mediating relationships were found, such as care recipient depressive behaviours mediating the relationships between caregiver burden and psychological quality of life. Future studies of the conceptual model will improve understanding of the predictors of carer mental well-being and enable tailored interventions to improve the psychological health of carers of adults on the autism spectrum.
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Affiliation(s)
- Marisse T Sonido
- Department of Developmental Disability Neuropsychiatry (3DN), the UNSW Sydney, Sydney, NSW, Australia.,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia
| | - Ye In Hwang
- The Kirby Institute, the UNSW Sydney, Sydney, NSW, Australia
| | - Preeyaporn Srasuebkul
- Department of Developmental Disability Neuropsychiatry (3DN), the UNSW Sydney, Sydney, NSW, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), the UNSW Sydney, Sydney, NSW, Australia.,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), the UNSW Sydney, Sydney, NSW, Australia. .,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, QLD, Australia.
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16
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Friesen KA, Weiss JA, Howe SJ, Kerns CM, McMorris CA. Mental Health and Resilient Coping in Caregivers of Autistic Individuals during the COVID-19 Pandemic: Findings from the Families Facing COVID Study. J Autism Dev Disord 2021; 52:3027-3037. [PMID: 34240291 PMCID: PMC8265288 DOI: 10.1007/s10803-021-05177-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 12/13/2022]
Abstract
Many caregivers of autistic people experience mental health issues, and the impact of disruptions due to COVID-19 may present additional challenges for these individuals. This study characterized caregiver stress, anxiety, and resilient coping during COVID-19 and investigated the impact of COVID-19 disruptions, demographic variables, and resilient coping on mental health. The majority of caregivers reported some degree of disruption associated with COVID-19, and more than half reported moderate levels of stress and high anxiety. Resilient coping did not emerge as a moderator between COVID-19 disruptions and caregiver mental health, but instead had a direct effect on outcomes. Future research is needed to understand additional factors impacting the mental health of caregivers of autistic people during the COVID-19 pandemic.
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Affiliation(s)
- Kelsey A Friesen
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Stephanie J Howe
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, EDT 508, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada.
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada.
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17
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Smith J, Sulek R, Abdullahi I, Green CC, Bent CA, Dissanayake C, Hudry K. Comparison of mental health, well-being and parenting sense of competency among Australian and South-East Asian parents of autistic children accessing early intervention in Australia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1784-1796. [PMID: 33896231 DOI: 10.1177/13623613211010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT We know that parents of autistic children experience poorer mental health and lower well-being than parents of non-autistic children. We also know that poorer mental health among parents of autistic children has been observed across different cultures. Most research focuses on Western cultures, so we know little about parental mental health and well-being of parents from different cultural backgrounds; yet, it is likely that cultural background contributes to how parents view their child's condition and respond to the diagnosis. Here, we compared mental health, quality of life and well-being between families raising an autistic child from Australian backgrounds to families from South-East Asian backgrounds. All children in the current study were receiving the same community-based early intervention. When compared to the general population, parents had poorer mental health overall, but there were no differences between the two groups of parents. However, parents from South-East Asian backgrounds reported higher well-being and fewer difficulties associated with their child's autism. These findings suggest that cultural background likely influences not only parent's view of, and response to, their child's autism, but also their own sense of well-being. As researchers and clinicians working with families of autistic children, we should more explicitly consider family's cultural background within our work.
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18
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Fitzgerald J, Gallagher L. Parental stress and adjustment in the context of rare genetic syndromes: A scoping review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629521995378. [PMID: 33866895 PMCID: PMC9168905 DOI: 10.1177/1744629521995378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 06/10/2023]
Abstract
Chromosomal abnormalities are now considered a common cause of intellectual disability. With increased genetic testing, phenotyping and technological advancements, many new syndromes have been identified. This review sought to explore parental stress and adjustment in the context of rare genetic syndromes to evaluate their clinical impact. A systematic review of English peer-reviewed literature across three databases (PsycINFO, Medline, CINAHL) was completed and 69 articles were included. Parents of children with rare genetic syndromes experienced greater distress relative to other disabilities. Differences in parental wellbeing were syndrome-specific relative to ASD thus demonstrating the need to consider the contribution of syndrome-specific phenotypes. Child emotional and behavioural difficulties were the most consistent predictor of parental distress. Research reflecting other factors such as physical health, syndrome-specific behaviours, benefit finding and, parental appraisal in the context of a rare genetic aetiology is required in order to support parental adjustment in these conditions.
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Affiliation(s)
| | - Louise Gallagher
- Trinity College Dublin, Ireland; Children Health Ireland at Tallaght Hospital, Ireland;
Cherry Orchard Hospital, Ireland
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19
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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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20
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Perier S, Callahan S, Séjourné N. Parents d’un enfant en situation de handicap : quelles difficultés, quels besoins ? PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Green CC, Smith J, Bent CA, Chetcuti L, Sulek R, Uljarević M, Hudry K. Differential predictors of well-being versus mental health among parents of pre-schoolers with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1125-1136. [PMID: 33472386 DOI: 10.1177/1362361320984315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Raising a child with autism has been linked to mental health difficulties. Poor parental mental health is likely influenced by various factors - including child-, parent-, and family/socioeconomic characteristics. However, little is known about what influences and promotes well-being (as opposed to mental health) among parents of young, newly diagnosed autistic children who may be particularly vulnerable. We examined child-, parent-, and family/socioeconomic factors associated with each of mental health and well-being in a sample of 136 parents of pre-school-aged children. Parental mental health was linked to both child- (i.e. autism symptom severity) and parent-related factors (i.e. personality traits reflecting a tendency to experience negative emotions). By contrast, in additional to mental health difficulties, which were linked to well-being, only other parent-related characteristics (and not child characteristics) were related to well-being. These included personality traits reflecting a tendency to be more extraverted/sociable, and also mindfulness. Other child-related and family/socioeconomic context factors (including household income, parental education level) were not linked to parental mental health or well-being in this sample. These results support the idea that poorer mental health and well-being are not simply the opposite of one another. That is, while these two factors were related, they were linked to different personal characteristics. Perhaps most importantly, the link between well-being and mindfulness - a personal characteristic that parents can improve - suggests mindfulness-based interventions may be helpful in directly supporting parental well-being in the context of raising a young child with autism.
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Affiliation(s)
| | | | | | | | - Rhylee Sulek
- La Trobe University, Australia.,Griffith University, Australia
| | - Mirko Uljarević
- The University of Melbourne, Australia.,Stanford University, USA
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22
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Marsack-Topolewski CN, Samuel PS, Tarraf W. Empirical evaluation of the association between daily living skills of adults with autism and parental caregiver burden. PLoS One 2021; 16:e0244844. [PMID: 33400706 PMCID: PMC7785247 DOI: 10.1371/journal.pone.0244844] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the joy of parenting, the burden of daily caregiving for children with autism spectrum disorders (ASD) can be overwhelming and constant. Parents can expect to provide enduring care for their children with ASD. Given that the majority of individuals with autism spectrum disorders (ASD) remain in their family homes well into adulthood, often the need for assistance with activities of daily living (ADLs) is placed on parents. Providing ongoing support to adult children who have difficulty with completing ADLs can increase parental caregiving demands. Therefore, the purpose of this study was to examine the relationship between the ability of adults with ASD to perform ADLs with parental perceptions of caregiver burden. METHODS Quantitative analysis of cross-sectional multi-state data gathered electronically using Qualtrics from 320 aging parents of adults with ASD was conducted. Regression models were fit to examine the association of ADL challenges with total caregiver burden and its four domains (emotional, financial, time dependence, and developmental). RESULTS Parental perceptions of caregiver burden decreased, particularly time dependence and developmental burden, when adult children were less dependent in ADLs, even after adjusting for parental health and behavioral challenges. CONCLUSIONS Findings support the need for family-centered interventions to improve the capacity of adults with ASD to perform ADLs independently.
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Affiliation(s)
| | - Preethy Sarah Samuel
- Occupational Therapy Program, Department of Health Care Sciences, Wayne State University, Detroit, Michigan, United States of America
| | - Wassim Tarraf
- Occupational Therapy Program, Department of Health Care Sciences, Wayne State University, Detroit, Michigan, United States of America
- Institute of Gerontology, Wayne State University, Detroit, Michigan, United States of America
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23
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Ma SW, Lai S, Yang YY, Zhou Z, Yang BT, Zheng GZY, Gao J, Lu L. Relationships Between Anxiety Symptoms, Hopelessness and Suicidal Ideation Among Parental Caregivers of Mandarin-Speaking Children With Speech Impairment: The Mediating Effect of Depressive Symptoms. Front Psychiatry 2021; 12:648885. [PMID: 33986701 PMCID: PMC8110902 DOI: 10.3389/fpsyt.2021.648885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/22/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Determining the mental health status of parents who chronically care for a child with speech impairment is important for developing appropriate interventions to improve both parents' and children's health and achieve a win-win situation. Unfortunately, no study in China has explored this issue. This study investigated the differences in four aspects of mental health between maternal and paternal caregivers for the Mandarin-speaking children with speech impairment and determine whether depressive symptoms mediate the relationships between anxiety symptoms and suicidal ideation, hopelessness and suicidal ideation. Methods: This cross-sectional questionnaire survey was conducted in February 2020 by sending a link to the predesigned electronic questionnaire in WeChat. Standardized assessment tools were employed. Hierarchical multiple logistic regression was conducted to examine the associations between various factors and suicidal ideation, and two separate structural equation models were performed to evaluate the mediating effects of depressive symptoms in the relationship between anxiety symptoms and suicidal ideation as well as between hopelessness and suicidal ideation. Results: This study included 446 parental caregivers of Mandarin-speaking children with speech impairment. Paternal caregivers had greater score than maternal caregivers on loss of motivation (one of the subdomains of hopelessness). Somatic complications of the child (OR = 2.73, 95% CI: 1.09-6.67) and depressive symptoms (OR = 3.38, 95% CI: 1.83-6.30) were positively associated with caregivers' suicidal ideation. Having speech therapy of child (OR = 0.54, 95% CI: 0.29-0.98) was negatively correlated with caregivers' suicidal ideation. There was direct effect of depressive symptoms on suicidal ideation. Depressive symptoms play mediating roles on the relationships between anxiety symptoms (β = 0.171, p < 0.001) as well as between hopelessness and suicidal ideation (β = 0.187, p < 0.001). Conclusions: Paternal and maternal caregivers of Mandarin-speaking children with speech impairment suffered from mental health problems. Preventive strategies and interventions to ameliorate parental psychological well-being, and health care policies to increase the accessibility to speech therapy care of children with speech impairment are imperative.
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Affiliation(s)
- Si-Wei Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,Research Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Yan-Yan Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin-Ting Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | | | - Jianmin Gao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- Team IETO, Bordeaux Population Health Research Center, INSERM, Université de Bordeaux, Bordeaux, France
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24
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Parker ML, Diamond RM, Auwood LH. Exploring Exceptions and Discovering Solutions: A Case Presentation of Autism and the Family. FAMILY PROCESS 2020; 59:1891-1902. [PMID: 31613401 DOI: 10.1111/famp.12500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.
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25
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Prediction of Quality of Life Based on Spiritual Intelligence and Resiliency in Mothers of Children with Behavioral Problems. HEALTH, SPIRITUALITY AND MEDICAL ETHICS 2020. [DOI: 10.52547/jhsme.7.3.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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26
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Berasategi N, Idoiaga N, Dosil M, Eiguren A. Design and Validation of a Scale for Measuring Well-Being of Children in Lockdown (WCL). Front Psychol 2020; 11:2225. [PMID: 33041894 PMCID: PMC7530232 DOI: 10.3389/fpsyg.2020.02225] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/10/2020] [Indexed: 01/24/2023] Open
Abstract
The objective of this study was to create and validate an instrument to measure the well-being of children in lockdown. As a response to the COVID-19 pandemic, and in the interest of maintaining social distancing, millions of people have been confined to their homes, including children, who have been withdrawn from school and barely able to leave their homes. Thus, it would be useful to evaluate, from a holistic perspective, the well-being of children under these challenging circumstances. The participants were 1,046 children, 48.7% of which were boys and 50.7% girls, recruited in the Basque Country (Northern Spain). The scale was answered by their parents. The survey, entitled "Well-being of Children in Lockdown" (WCL), is composed of six subscales: Emotions, Playful and creative activities, Education, Addictions, Routine, and Physical Activity. Exploratory factor analyses indicate that all the reliability indices were acceptable. The survey demonstrated adequate reliability (alpha = 0.804). We were thus able to confirm the validity of this simple instrument for evaluating the well-being of children aged between 4 and 12 years in lockdown situations. The WCL can be regarded as a useful tool to evaluate the well-being of children in lockdown situations.
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Affiliation(s)
- Naiara Berasategi
- Department of Didactics and School Organisation, University of the Basque Country - UPV/EHU, Bilbao, Spain
| | - Nahia Idoiaga
- Department of Evolutionary and Educational Psychology, University of the Basque Country - UPV/EHU, Bilbao, Spain
| | - Maria Dosil
- Department of Research and Diagnostic Methods in Education, University of the Basque Country - UPV/EHU, Bilbao, Spain
| | - Amaia Eiguren
- Department of Didactics and School Organisation, University of the Basque Country - UPV/EHU, Bilbao, Spain
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27
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Samadi H, Samadi SA. Understanding Different Aspects of Caregiving for Individuals with Autism Spectrum Disorders (ASDs) a Narrative Review of the Literature. Brain Sci 2020; 10:E557. [PMID: 32824109 PMCID: PMC7463436 DOI: 10.3390/brainsci10080557] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND There has been a considerable endeavor to understand associated challenges of caregiving for a child with Autism Spectrum Disorders (ASDs) and to develop the necessary skills and approaches to assist parents of children with ASD. Different studies have been stressed the importance and need for parental involvement in the intervention process to increase positive impacts. METHODS The process of caregiving and the associated challenges should be understood from different aspects to be able to facilitate parent involvement in intervention implementation. In a narrative literature review, ten selected reviews were considered and each review considered a special aspect of caregiving for an individual with ASD. RESULTS Five main different factors in the available literature and reviews were considered as different themes that needed to be reconsidered in the studies on the impacts of caregiving for an individual with ASD. CONCLUSIONS It is concluded that to facilitate parental involvement in the intervention process, and to support caregivers of this group of individuals this review highlights the need for improved research in some proposed areas in this field and to bridge the gap between research and practice in this field.
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Affiliation(s)
- Hadi Samadi
- Department of Philosophy, Faculty of Law, Theology and Political Science, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran
| | - Sayyed Ali Samadi
- Institute of Nursing Research, University of Ulster, Newtownabbey BT37 0QB, Northern Ireland, UK;
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Lovell B, Wetherell MA. Exploring the Moderating Role of Benefit Finding on the Relationship Between Child Problematic Behaviours and Psychological Distress in Caregivers of Children with ASD. J Autism Dev Disord 2020; 50:617-624. [PMID: 31724121 DOI: 10.1007/s10803-019-04300-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Caregivers of children with ASD often find benefits associated with their caregiving role, and benefit finding predicts lower distress. Child problematic behaviours (CPB), which positively predict caregivers' distress, are perceived to be being less problematic, or more manageable, by caregivers who find benefits. Benefit finding therefore might mitigate the negative psychological impact of CPB. A sample of n = 158 caregivers of children with ASD completed an online survey assessing benefit finding, CPB, and psychological distress. CPB positively, and benefit finding negatively, predicted caregivers' distress. Moderation effects however were not observed. Findings implicate increased CPB and lower benefit finding as risk factors for caregivers' psychological distress. Findings provide clearly definable targets for intervention.
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Affiliation(s)
- Brian Lovell
- Department of Psychology, Northumbria University, Northumberland Building, Northumberland Road, Newcastle upon Tyne, NE1 8ST, UK.
| | - Mark A Wetherell
- Department of Psychology, Northumbria University, Northumberland Building, Northumberland Road, Newcastle upon Tyne, NE1 8ST, UK
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Brief Report: Preliminary Outcomes of a Peer Counselling Program for Parents of Children with Autism in the South Asian Community. J Autism Dev Disord 2020; 51:334-340. [PMID: 32419042 DOI: 10.1007/s10803-020-04538-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Peer volunteers have been found to be effective in delivering psychosocial interventions when they come from the same culture and share similar experiences as participants. We examined the clinical utility (feasibility and preliminary effectiveness) of a community-based, manualized, peer-delivered group counselling program to address the need for culturally responsive counselling for parents of children with autism in the South Asian community. Sixty-three parents (Mage = 43.7 years, 68% mothers) participated in the program, and reported high stable program satisfaction across sessions. Further, parents reported improved mental health and quality of life following involvement in the program, with changes noted even after the first session. Further research is warranted to assess the efficacy of this kind of parent support intervention.
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Salomone E, Settanni M, Ferrara F, Salandin A. The Interplay of Communication Skills, Emotional and Behavioural Problems and Parental Psychological Distress. J Autism Dev Disord 2020; 49:4365-4374. [PMID: 31368058 DOI: 10.1007/s10803-019-04142-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We investigated the mechanism of impact of poor communication skills and emotional and behavioural problems in children with ASD (22-61 months) on parental psychological distress. Participants were dyads enrolled in two pilot intervention studies; the dataset includes cross-sectional data at baseline (N = 82). We postulated an indirect effect of child expressive and receptive communication on parent psychological distress, through child emotional and behavioural problems. The effect of receptive skills on parent psychological distress was fully mediated by child emotional problems: lower receptive skills were associated with higher levels of emotional symptoms, which in turn predicted higher parent psychological distress. Expressive skills did not show either direct or indirect effects. Findings are discussed in light of children's marked 'receptive disadvantage' communication profile.
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Affiliation(s)
- Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Milan, Italy.
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Toledano-Toledano F, Rodríguez-Rey R, Moral de la Rubia J, Luna D. A Sociodemographic variables questionnaire (Q-SV) for research on family caregivers of children with chronic disease. BMC Psychol 2019; 7:85. [PMID: 31864414 PMCID: PMC6925508 DOI: 10.1186/s40359-019-0350-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/11/2019] [Indexed: 12/13/2022] Open
Abstract
Background Chronic diseases in childhood can affect the physical and mental health of patients and their families. The literature on pediatric chronic diseases has found important associations between the sociodemographic variables of children and their caregivers and negative health consequences in families. Methods In this study, we aimed to design and validate a questionnaire on sociodemographic variables that would be useful for research on pediatric chronic diseases; and investigate the relationship between sociodemographic variables and psychosocial variables among family caregivers. First, we created a questionnaire that consists of 20 demographic, medical, and family-related items based on a literature review and expert evaluations. This questionnaire was then validated by 335 expert reviewers in the field of Social Work, who work daily with the families of patients with chronic diseases in 10 National Institutes of Health of Mexico. The validation was based on three empirical criteria created specifically for this study, and the reviewers evaluated the usefulness, relevance, and permanence of the items. In a second cross-sectional, correlational and comparative study, a total of 446 family caregivers of children with chronic diseases were interviewed, and they completed the Sociodemographic Variables Questionnaire for research on family caregivers of children with chronic sociodemographic diseases and four psychosocial measurement instruments for evaluating anxiety, depression, caregiver burden and quality of life. Results Based on the results of the first study, we created the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic diseases, and it includes 17 items that assess demographic, medical, and family characteristics. The results of the second study showed that the 17 sociodemographic variables obtained in the validation by expert judges are useful for measuring and evaluating the relationship between psychosocial variables in families of children with chronic diseases. Conclusions Psychosocial and sociodemographic factors are relevant for the development of research processes for families that care for children with chronic diseases.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, Doctores, Cuauhtémoc, 06720, México City, Mexico.
| | - Rocío Rodríguez-Rey
- Universidad Europea de Madrid. Calle Tajo, s/n, 28670 Villaviciosa de Odón, Madrid, Spain
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León. Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, 64460, Monterrey, Mexico
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-10° Piso, esq. Eje 5 Sur (Eugenia). Col. Narvarte, 03020, Benito Juárez, Mexico City, Mexico
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The Developmental Behaviour Checklist (DBC) Profile in Young Children on the Autism Spectrum: The Impact of Child and Family Factors. J Autism Dev Disord 2019; 49:3426-3439. [PMID: 31115773 DOI: 10.1007/s10803-019-04067-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
High levels of emotional/behavioural difficulties are frequently reported in children on the autism spectrum. However, given the diversity in profiles, there is a need to explore such behaviours in relation to individual factors. Parents of 130 children aged 4-5 on the autism spectrum completed measures of behaviour and adaptive behaviour. Hierarchical multiple regressions explored child and family characteristics in relation to children's emotional/behavioural presentation. Different aspects of the behavioural profile were associated with different factors, with child autism characteristics, medication use, and parent mental health making significant unique contributions to a range of behavioural subscales. Understanding individual profiles beyond total scores is therefore needed to truly understand the emotional and behavioural profile of specific subgroups.
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DesChamps TD, Ibañez LV, Edmunds SR, Dick CC, Stone WL. Parenting stress in caregivers of young children with ASD concerns prior to a formal diagnosis. Autism Res 2019; 13:82-92. [PMID: 31593362 DOI: 10.1002/aur.2213] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/07/2019] [Accepted: 09/10/2019] [Indexed: 11/12/2022]
Abstract
Robust findings demonstrate that parents of children with autism spectrum disorder (ASD) experience high levels of parenting stress that are associated with negative outcomes for families. Although the majority of research on parenting stress has focused on parents of children with an existing diagnosis, parents of young children with concerns about ASD-related behaviors also face many unique challenges before the time of diagnosis. However, no study to date has examined patterns of parenting stress among parents of children with ASD concerns prior to a formal ASD diagnosis. Therefore, the current study investigated longitudinal trajectories of parenting stress among parents of young children with ASD concerns compared to parents of children with non-ASD developmental concerns (e.g., language delay), and parents of children with no developmental concerns. Known predictors of parenting stress were also examined. Results from multilevel model analyses revealed that parents of children with ASD concerns experienced consistently higher levels of parenting stress across early child development compared to parents of children with non-ASD developmental concerns and those with no concerns. Additionally, parenting efficacy, psychological functioning, social satisfaction, and child social communication behaviors predicted levels of parenting stress for all parents. Autism Res 2020, 13: 82-92. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examined parenting stress across time among parents of young children with ASD concerns before receiving a diagnosis. Parents of children with ASD concerns reported consistently higher levels of parenting stress compared to parents of children with other developmental concerns and parents of children with no concerns. Also, ASD concerns predicted parenting stress in addition to other parent and child predictors of parenting stress. These findings highlight the need to better support families before an ASD diagnosis.
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Affiliation(s)
- Trent D DesChamps
- Department of Psychology, University of Washington, Seattle, Washington
| | - Lisa V Ibañez
- Department of Psychology, University of Washington, Seattle, Washington
| | - Sarah R Edmunds
- Department of Psychology, University of Washington, Seattle, Washington
| | - Catherine C Dick
- Department of Psychology, University of Washington, Seattle, Washington
| | - Wendy L Stone
- Department of Psychology, University of Washington, Seattle, Washington
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Tarver J, Palmer M, Webb S, Scott S, Slonims V, Simonoff E, Charman T. Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1630-1644. [PMID: 30818965 DOI: 10.1177/1362361319830042] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There is growing interest in the development of behavioral parent interventions targeting emotional and behavioral problems in children with autism spectrum disorders. Such interventions have potential to improve a number of child and parental well-being outcomes beyond disruptive child behavior. This systematic review and meta-analysis assesses evidence for the efficacy of behavioral parent interventions for disruptive and hyperactive child behavior in autism spectrum disorders, as well as parenting efficacy and stress. A total of 11 articles from nine randomized controlled trials were included. Sufficient data were available to calculate standardized mean difference and show favorable effects of behavioral parent interventions on parent-reported measures of child disruptive behavior (standardized mean difference = 0.67), hyperactivity (standardized mean difference = 0.31) and parent stress (standardized mean difference = 0.37); effects on parent efficacy are less clear (standardized mean difference = 0.39, p = 0.17). There were insufficient data to explore intervention effects on internalizing behavior in autism spectrum disorders, parenting behaviors, or observational and teacher-reported outcomes, providing important avenues for future research. This review adds to growing evidence of the efficacy of behavioral parent interventions for child behavior and parental well-being in autism spectrum disorders (Prospero: CRD42016033979).
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The Role of Choice and Control in the Impact of Autism Waiver Services on Family Quality of Life and Child Progress. J Autism Dev Disord 2019; 49:2035-2048. [DOI: 10.1007/s10803-019-03886-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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36
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Salomone E, Shephard E, Milosavljevic B, Johnson MH, Charman T. Adaptive Behaviour and Cognitive Skills: Stability and Change from 7 Months to 7 Years in Siblings at High Familial Risk of Autism Spectrum Disorder. J Autism Dev Disord 2018; 48:2901-2911. [PMID: 29616486 PMCID: PMC6096837 DOI: 10.1007/s10803-018-3554-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cognitive and adaptive behaviour abilities early in life provide important clinical prognostic information. We examined stability of such skills in children at high familial risk for ASD who either met diagnostic criteria for ASD at age 7 years (HR-ASD, n = 15) or did not (HR-non-ASD, n = 24) and low-risk control children (LR, n = 37), prospectively studied from infancy. For both HR groups, cognitive skills were consistently lower across time than those of LR children. HR-ASD children showed increasing difficulties in adaptive behaviour over time compared to LR children, while the HR-non-ASD children showed no such difficulties. This pattern of change may inform our understanding of developmental profiles of HR siblings beyond core ASD symptoms.
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Affiliation(s)
- Erica Salomone
- Department of Psychology, University of Turin, Via Po, 14, 10123, Turin, Italy.
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Elizabeth Shephard
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Bosiljka Milosavljevic
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Eskow KG, Summers JA. Family perceptions of the impacts of a home and community based services autism waiver: Making family life possible. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:159-171. [PMID: 30151875 DOI: 10.1111/jar.12518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/17/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND An important mechanism that provides support and services for families with a child/youth with autism spectrum disorder is the home- and community-based services (HCBS) Waiver authorized by Section 1915(c) of the Social Security Act or Medicaid. METHODS This study used qualitative research methods to explore parent perspectives about the impact of HCBS Waiver services on the child/youth with autism and their family. In-depth interviews focused on aspects of the programme they valued, identification of barriers and general issues they experienced. RESULTS Results of the qualitative study indicated that improved outcomes could be explained by providers of services who were well-trained, flexible and allowed parents' opportunities for choice regarding provision of services to meet child/youth and family needs. CONCLUSION The findings of this study provide guideposts for further research about factors that contribute to satisfaction of families receiving waiver services for quality of life and child progress.
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Affiliation(s)
| | - Jean Ann Summers
- Research & Training Center on Independent Living, Life Span Institute, University of Kansas, Lawrence, Kansas
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