Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being.
"These findings must be interpreted cautiously since improvement in depression resulted when established cutoffs (scores ≥16) for depression were used, whereas analysis of continuous depression scores showed no significant findings. Nonetheless, our study is one of the first rigorous long-term studies to show a reduction in depression after intensive intervention.55–57 "
[Show abstract][Hide abstract] ABSTRACT: Objective:
To evaluate the effectiveness of the Play and Language for Autistic Youngsters (PLAY) Project Home Consultation model, in combination with usual community services (CS), to improve parent-child interaction, child development, and autism symptomatology in young children with autism spectrum disorders (ASDs) compared with CS only.
Children (N = 128) with autism or PDD-NOS (DSM-4 criteria) aged 2 years 8 months to 5 years 11 months and recruited from 5 disability agencies in 4 US states were randomized in two 1-year cohorts. Using videotape and written feedback within a developmental framework, PLAY consultants coached caregivers monthly for 12 months to improve caregiver-child interaction. CS included speech/language and occupational therapy and public education services. Primary outcomes included change in parent-child interactions, language and development, and autism-related diagnostic category/symptoms. Secondary outcomes included parent stress and depression and home consultant fidelity. Data were collected pre- and post-intervention.
Using intent-to-treat analysis (ITT), large treatment effects were evident for parent and child interactional behaviors on the Maternal and Child Behavior Rating Scales. Child language and developmental quotient did not differ over time by group, although functional development improved significantly. PLAY children improved in diagnostic categories on the Autism Diagnostic Observation Schedule (ADOS). PLAY caregivers' stress did not increase, and depressive symptomatology decreased. Home consultants administered the intervention with fidelity.
PLAY intervention demonstrated substantial changes in parent-child interaction without increasing parents' stress/depression. ADOS findings must be interpreted cautiously because results do not align with clinical experience. PLAY offers communities a relatively inexpensive effective intervention for children with ASD and their parents.
Journal of developmental and behavioral pediatrics: JDBP 10/2014; 35(8):475-485. DOI:10.1097/DBP.0000000000000096 · 2.13 Impact Factor
"However, psychological distress, indexed by anxiety and depressive symptoms, was not significantly different in mothers of children with ASD compared with mothers in the DD and TYP groups. This differs from prior research with mothers of preschool-aged children with ASD (e.g., ) and from one study of parents of children with ASD of this same age group . Consistent with previous literature, child problem behavior was found to significantly contribute to parenting-related stress and psychological distress in mothers of children with ASD and DD (e.g., ). "
[Show abstract][Hide abstract] ABSTRACT: Background:Parents of children with autism spectrum disorders (ASDs) are at risk for higher stress levels than parents of children with other developmental disabilities and typical development. Recent advances in early diagnosis have resulted in younger children being diagnosed with ASDs but factors associated with parent stress in this age group are not well understood. Aims: The present study examined parenting-related stress and psychological distress in mothers of toddlers with ASD, developmental delay without ASD (DD), and typical development. The impact of child problem behavior and daily living skills on parenting-stress and psychological distress were further investigated. Methods: Participants were part of a larger research study on early ASD intervention. Results: Parent self-report of parenting-related stress and psychological distress was utilized. Parents of toddlers with ASD demonstrated increased parenting-related stress compared with parents of toddlers with DD and typical development. However, psychological distress did not differ significantly between the groups. Child behavior problems, but not daily living skills emerged as a significant predictor of parenting-related stress and psychological distress. This was true for both mothers of children with ASD and DD. Conclusions: These finding suggest that parents' abilities to manage and reduce behavior problems is a critical target for interventions for young children with ASD and DD in order to improve child functioning and decrease parenting-related stress.
Brain & development 11/2012; 35(2). DOI:10.1016/j.braindev.2012.10.004 · 1.88 Impact Factor
"Perhaps the most commonly used measure of parenting stress throughout both ASD and other literature is the PSI (Abidin 1995), while the associated Stress Index for Parents of Adolescents (SIPA; Sheras et al. 1998) is commonly used with parents of teenagers. Studies using the PSI full or short form (e.g., Davis and Carter 2008; Hoffman et al. 2009; Ingersoll and Hambrick 2011; Rao and Beidel 2009) suggest strong internal consistency and validity in use with the ASD population, while Ozonoff et al. (2005) identified the SIPA as a psychometrically sound measure for use with parents of adolescents with ASD. Lecavalier et al. (2006) noted that, when utilizing the PSI Short Form (PSI-SF) with parents of children with ASD, 57.7 % of these parents scored in the clinically significant range compared with the normative sample for the measure. "
[Show abstract][Hide abstract] ABSTRACT: Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.
Clinical Child and Family Psychology Review 08/2012; 15(3):247-77. DOI:10.1007/s10567-012-0119-6 · 4.75 Impact Factor
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