Article

Parenting aggravation and autism spectrum disorders: 2007 National Survey of Children's Health

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Disability and Health Journal (Impact Factor: 1.5). 07/2011; 4(3):143-52. DOI: 10.1016/j.dhjo.2010.09.002
Source: PubMed

ABSTRACT Studies suggest autism spectrum disorders (ASDs) are associated with high parenting stress and aggravation. Research on specific risk factors is needed. OBJECTIVE/HYPOTHESES: To assess aggravation level among parents of children with and without ASDs.
The sample of 73,030 children aged 4 to 17 years in the 2007 National Survey of Children's Health and their parent respondents were divided into mutually exclusive groups based on child ASD status and other special health care needs. Adjusted prevalence ratios (aPR) for associations between a high Aggravation in Parenting scale score and various risk factors were computed from multivariable models.
High-aggravation percentages were comparable for parents of children with a current ASD (36.6%), ASD reported previously but not currently (35.2%), and another (non-ASD) developmental problem (31.2%) but were significantly lower for parents of children with other special health care needs (6.5%) and no special health care needs (5.1%). Within the current-ASD group, high aggravation was associated with young child age (aPR = 1.8 [1.2-2.6]), lack of health insurance (aPR = 1.5 [1.0-2.4]), lack of a medical home (aPR = 2.2 [1.4-3.5]), recent child mental health treatment (aPR = 2.1 [1.5-3.0]), lack of parenting emotional support (aPR = 1.5 [1.1-2.1]), and ASD severity (aPR = 1.4 [1.0-1.6]). Some of these same factors were associated with aggravation in the non-ASD groups. However, the medical home finding was specific to the ASD groups.
Parenting a child with ASD is associated with high aggravation; however, there is variability within health care and social support subgroups. Strategies to strengthen medical home components for children with ASDs should be considered.

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    ABSTRACT: Background: The difficulties of children with Autism Spectrum Disorders (ASD) affect caregivers across a variety of domains. The impact of having a child with ASD appears to reverberate throughout the entire family system, and ultimately has transactional effects on the diagnosed child. Interventions for ASD do not necessarily ameliorate, and may even exacerbate, parent and family distress. Thus, comprehensive evaluation of interventions should include assessment of parent and family domains. The Program for the Education and Enrichment of Relationship Skills (PEERS; Laugeson & Frankel, 2009) is a manualized, evidence-based, social skills training intervention for adolescents with ASD. Parents participate in a concurrent, separate group designed to teach PEERS concepts to parents, generalize teen practice of skills outside of group, and troubleshoot issues with assignment completion and development of new teen friendships. Though numerous studies have suggested positive outcomes for teens following PEERS, no research has evaluated parent and family outcomes. Objectives: The purpose of this study is to understand how participation in PEERS intervention affects parents and families of teenagers with ASD in terms of parenting efficacy, parenting stress, the parent-child relationship, and family functioning. Methods: Sixteen parent-child dyads were randomly assigned to an “Experimental” (n = 8) or “Waitlist Control” (n=8) group for PEERS intervention. Parents in both groups completed the following measures at pre and post intervention: The parenting efficacy subscale of the Parenting Sense of Competency (PSOC); the Stress Index for Parents of Adolescents (SIPA), the Parenting Relationship Questionnaire (PRQ), and the Parent-Child Relationship Inventory (PCRI). Teenagers with ASD and their parents in the Experimental group then participated in 14 weeks of 1.5 hour sessions focusing on initiating and maintaining friendships. Mixed between-within subjects Analysis of Variance (ANOVA) was conducted to assess differences between groups over time. Results: Results indicated a significant interaction effect between treatment condition and time, suggesting a reduction in total parenting stress in the Experimental group in comparison to the Waitlist Control group from pre- to post-PEERS intervention, F (1,13) = 9.74, p = .008, η2 = .428. Additionally, there was a trend toward significant interaction effects between treatment condition and time for child autonomy, suggesting an increase in parent ratings of child autonomy within the Experimental group compared to the Waitlist Control group, F(1,14) = 3.47, p = .083, η2 = .199. Finally, main effects analysis indicated that parents across groups experienced a significant decrease in relational frustration, F(1,13) = 24.13, p < .001, η2 = .650, and family chaos, F(1,14) = 5.34, p = .037, η2 = .276; along with a significant increase in parenting efficacy, F (1,14) = 17.05, p = .001, η2 = .549. Conclusions: These results suggest that significant, positive changes occur in parents and families of adolescents with ASD following involvement in PEERS. Specifically, parents participating in PEERS experienced decreased parenting stress following the intervention. Further, the parent-adolescent interaction following PEERS appears to facilitate increased teen autonomy, a developmentally important trajectory. In conjunction with previous literature on PEERS, these findings highlight the comprehensive benefits of this intervention.
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